Published: 2022-07-26

Pancreatectomy for metastatic renal cell carcinoma: twenty years of experience at a tertiary centre

Richard Y. Chou, Daniel Daly, Pearl Wong, Rafael Gaszynski, Christos Apostolou, Neil Merrett


Renal Cell Carcinoma (RCC) accounts for approximately 90% of primary renal malignancies, of which the clear cell subtype is most common. While metastatic disease is common at the time of diagnosis and generally confers a poor prognosis, metastatic RCC may demonstrate relatively indolent behaviour and present many years after resection of the primary tumour, including to the pancreas. The available literature suggested that surgical resection was appropriate for select patients, including those with a solitary pancreatic metastasis, minimal comorbidities and uncomplicated progress from initial treatment of their primary renal malignancy. A retrospective case series of patients presenting with RCC metastases to the pancreas, managed via surgical resection at a tertiary teaching hospital was reviewed. Analysis of patient demographics, investigations, management and outcomes were performed, with a focus on post-operative morbidity and overall survival. Between 2000 and 2020, 7 patients underwent pancreatic resection of RCC metastases at our tertiary teaching hospital with curative intent. Median age at time of resection was 66 years. No post-operative mortality or major morbidity was experienced by the 7 patients, although 4 patients developed some degree of pancreatic insufficiency. Four patients experienced recurrent metastatic RCC, with median time to recurrence of 3.5 years. This was the largest local study to describe an Australian experience of the surgical management of RCC pancreatic metastases. These patients are frequently afforded prolonged survival following pancreatic resection, but often develop other distant sites of disease and second renal tumours.



Pancreatectomy, Metastatic renal cell carcinoma, Tumour

Full Text:



Hsieh JJ, Purdue MP, Signoretti S. Renal cell carcinoma. Nat Rev Dis Primers. 2017:3:170-09.

Singh D. Current updates and future perspectives on the management of renal cell carcinoma. Life Sciences. 2021;264:118632.

Capitanio U, Bensalah K, Bex A. Epidemiology of Renal Cell Carcinoma. Eur Urol. 2019;75(1):74-84.

Padala SA, Barsouk A, Thandra KC. Epidemiology of Renal Cell Carcinoma. World J Oncol. 2020:11(3):79-87.

Diaz de Leon A, Pirasteh A, Costa DN. Current Challenges in Diagnosis and Assessment of the Response of Locally Advanced and Metastatic Renal Cell Carcinoma. Radio Graphics. 2019;39:998-1016.

Janiszewska AD, Poletajew S, Wasiutyński A. Spontaneous regression of renal cell carcinoma. Contemp Oncol (Pozn). 2013:17(2):123-7.

Maruschke M, Anastasiadis AG, Hakenberg OW. Spontaneous regression of renal cell carcinoma: Reality or myth? World J Clin Urol. 2014;3(3):201-8.

Siebels M, Schendel D. New challenges and chances in the treatment of metastatic renal cell carcinoma. World J Urol. 2005;23:153-4.

Untch BR, Allen PJ. Pancreatic Metastasectomy: The Memorial Sloan-Kettering Experience and a Review of the Literature. J Surg Oncol. 2014;109(1):28-30.

Di Franco G, Gianardi D, Palmeri M. Pancreatic resections for metastases: A twenty-year experience from a tertiary care center. Eur J Surg Oncol. 2020;46(5):825-31.

Bamias A, Escudier B, Sternberg CN, Zagouri F. Current Clinical Practice Guidelines for the Treatment of Renal Cell Carcinoma: A Systematic Review and Critical Evaluation. Oncologist. 2017;22(6):667-79.

Reddy S, Wolfgang CL. The role of surgery in the management of isolated metastases to the pancreas. Lancet Oncol. 2009;10(3):287-93.

Tanis PJ, van der Gaag NA, Busch ORC, van Gulik TM, Gouma, DJ. Systematic review of pancreatic surgery for metastatic renal cell carcinoma. Br J Surg. 2009;96(6):579-92.

Ouzaid I, Capitanio U, Staehler M. Surgical Metastasectomy in Renal Cell Carcinoma: A Systematic Review. Eur Urol Oncol. 2019;2(2):141-49.

Longo N, Capece M, Celentano G. Clinical and Pathological Characteristics of Metastatic Renal Cell Carcinoma Patients Needing a Second-Line Therapy: A Systematic Review. Cancers (Basel). 2020;12(12):3634.

Buti S, Bersanelli M, Sikokis A. Chemotherapy in metastatic renal cell carcinoma today? A systematic review. Anticancer Drugs. 2013;24(6):535-54.

Gong J, Maia MC, Dizman N, Govindarajan A, Pala SK. Metastasis in renal cell carcinoma: Biology and implications for therapy. Asian J Urol. 2016;3(4):286-92.

Anderson B, Williams GA, Sanford DE, Liu J, Dageforde LA, Hammill CW, et al. A 22-year experience with pancreatic resection for metastatic renal cell carcinoma. HPB (Oxford). 2020;22(2):312-17.