Clinical characteristics of 7 renal cell carcinoma patients developing a solitary pancreatic metastasis after nephrectomy

BACKGROUND:A solitary metastasis from renal cell carcinoma is rarely occurred evidence. Therefore, we intended to study on the clinical characteristics of those patients who developed a solitary pancreatic metastasis after nephrectomy. METHODS:Of seven hundred and fifty-two patients with renal cell carcinoma (RCC) who had been treated during the past 38 years, 7 patients developed a solitary pancreatic metastasis after nephrectomy. We studied on the clinical characteristics, treatment modalities and prognosis of these 7 patients. RESULTS:Regarding the age distribution at the time of nephrectomy, the median age was 48 years old. Therefore, the median age of patients developing a pancreatic metastasis was 10 years younger than that of the whole group of RCC. Regarding the sex ratio of these 7 patients, there was no difference between the male and female group (male in 4, female in 3). Therefore, relatively higher rate of pancreatic metastasis in female patients was observed compared with the male counterpart. Furthermore, no difference in the affected side of the primary tumour was observed in these 7 patients (left in 4, right in 3). Regarding the stages at the time of nephrectomy, a majority of patients (85.7%) showed low stages (stages 1 and 2). As to the grade of primary lesion, a majority of these tumours (85.7%) showed low grades (grades I and II). In an analysis of the interval from the time of nephrectomy to the pancreatic metastasis, the median interval was 140 months. Therefore, the percentage of the late recurrent patients was 71.4%. As to the site of metastasis in the pancreas, various sites in the pancreas was affected, with dominant site being its body. The median size of metastatic lesion was 4.25 cm. Regarding the treatment of pancreatic metastasis, resection of the metastasis was performed in 5 patients, and the remaining 2 patients received chemotherapy in combination with administration of interferon. As to the clinical courses of these 7 patients, other organs became involved with metastases in 6 patients, and 5 of them died with the median survival of 18 months. Furthermore, of the remaining 2 patients, one survived for 73 months with persistent cancer, and the other survived for 4 months without cancer. CONCLUSION:In conclusion, renal cell carcinoma accompanied by later development of pancreatic metastasis tend to occur in younger patients and have higher incidence in females than in males when compared with otherwise similar renal cell carcinomas. Furthermore, they tend to be of low stage and grade, have longer intervals to the occurrence of metastasis and carry a poor prognosis.