Surgical-only treatment of pancreatic and extra-pancreatic metastases from renal cell carcinoma - quality of life and survival analysis.
Pancreatic metastases
Pancreatic resection
Quality of Life; cost-effectiveness.
RCC
Renal cell carcinoma
Robotic surgery
Journal
BMC surgery
ISSN: 1471-2482
Titre abrégé: BMC Surg
Pays: England
ID NLM: 100968567
Informations de publication
Date de publication:
13 May 2020
13 May 2020
Historique:
received:
12
05
2019
accepted:
28
04
2020
entrez:
15
5
2020
pubmed:
15
5
2020
medline:
7
10
2020
Statut:
epublish
Résumé
Treatment of pancreatic metastases (PM) from renal cell carcinoma (RCC) is still an issue between surgeons and oncologists, in the era of target-therapy. Data from 26 patients undergoing resection of PM and extra-PM from RCC, with R0 intention were retrospectively analysed. No one received adjuvant chemotherapy. Patients were divided into two groups; Group A comprehends 14 patients who developed synchronous (5) or methacronous (9) extra-PM. Group B comprehends 12 patients that developed PM only. No intraoperative mortality was recorded. Complications occurred in 14 patients (53.8%), all but 2 (7.26%) were graded I and II according to Clavien-Dindo classification. Recurrences occurred in 8 patients (30.8%), of whom, 5 (62.5%) were submitted for further resections in other sites. Three-, five- and ten-year observed overall survival were respectively 88,5% [95%CI: 0,56 - 1,33], 76,9% [95%CI: 0,47 - 1,19] and 50% [95%CI: 0,20 - 1,03]. Disease-free survival was 65,4% [95%CI: 0,38 - 1,05], at 3 years, 57,7% [95%CI 0,323 - 0,952] at 5 years and 42,9% [95%CI 0,157 - 0,933], at 10 years. QoL analysis, through WHOQOL-BREF questionnaire, assessed at last available follow up revealed a mean score of 75,9 ± 11,6 on 100 points. Despite no significant differences in survival between patients affected by Pancreatic or Extra-Pancreatic metastases, PM patients seems to show better outcome when managed surgically. mRCC patients, eligible for radical metastasectomy, tend to have long survival rates, reduced recurrence rates and good QoL. This paper was registered retrospectively in ClinicalTrials.gov with Identification number: NCT03670992.
Sections du résumé
BACKGROUND
BACKGROUND
Treatment of pancreatic metastases (PM) from renal cell carcinoma (RCC) is still an issue between surgeons and oncologists, in the era of target-therapy.
METHODS
METHODS
Data from 26 patients undergoing resection of PM and extra-PM from RCC, with R0 intention were retrospectively analysed. No one received adjuvant chemotherapy. Patients were divided into two groups; Group A comprehends 14 patients who developed synchronous (5) or methacronous (9) extra-PM. Group B comprehends 12 patients that developed PM only.
RESULTS
RESULTS
No intraoperative mortality was recorded. Complications occurred in 14 patients (53.8%), all but 2 (7.26%) were graded I and II according to Clavien-Dindo classification. Recurrences occurred in 8 patients (30.8%), of whom, 5 (62.5%) were submitted for further resections in other sites. Three-, five- and ten-year observed overall survival were respectively 88,5% [95%CI: 0,56 - 1,33], 76,9% [95%CI: 0,47 - 1,19] and 50% [95%CI: 0,20 - 1,03]. Disease-free survival was 65,4% [95%CI: 0,38 - 1,05], at 3 years, 57,7% [95%CI 0,323 - 0,952] at 5 years and 42,9% [95%CI 0,157 - 0,933], at 10 years. QoL analysis, through WHOQOL-BREF questionnaire, assessed at last available follow up revealed a mean score of 75,9 ± 11,6 on 100 points.
CONCLUSION
CONCLUSIONS
Despite no significant differences in survival between patients affected by Pancreatic or Extra-Pancreatic metastases, PM patients seems to show better outcome when managed surgically. mRCC patients, eligible for radical metastasectomy, tend to have long survival rates, reduced recurrence rates and good QoL.
STUDY REGISTRATION
BACKGROUND
This paper was registered retrospectively in ClinicalTrials.gov with Identification number: NCT03670992.
Identifiants
pubmed: 32404091
doi: 10.1186/s12893-020-00757-0
pii: 10.1186/s12893-020-00757-0
pmc: PMC7218538
doi:
Banques de données
ClinicalTrials.gov
['NCT03670992']
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
101Références
Ann Surg Oncol. 2014 Nov;21(12):4007-13
pubmed: 24879589
Pancreas. 2018 Sep;47(8):1033-1039
pubmed: 30048381
JAMA. 1963 Sep 21;185:914-9
pubmed: 14044222
Surgery. 2017 Mar;161(3):584-591
pubmed: 28040257
Gerontologist. 1969 Autumn;9(3):179-86
pubmed: 5349366
Surgery. 2007 Nov;142(5):761-8
pubmed: 17981197
Br J Surg. 2009 Jun;96(6):579-92
pubmed: 19434703
Qual Life Res. 2004 Mar;13(2):299-310
pubmed: 15085902
Pancreas. 2018 Apr;47(4):368-375
pubmed: 29521939
Cancer Treat Rev. 2018 Nov;70:127-137
pubmed: 30173085
PLoS One. 2016 Apr 11;11(4):e0151662
pubmed: 27064898
Anticancer Res. 2016 Aug;36(8):4273-8
pubmed: 27466543
J Natl Compr Canc Netw. 2017 Jun;15(6):804-834
pubmed: 28596261
Curr Med Res Opin. 2015;31(10):1933-40
pubmed: 26368665
J Clin Epidemiol. 1994 Nov;47(11):1245-51
pubmed: 7722560
Ann Surg Oncol. 2015;22(6):2094-100
pubmed: 25472645
Eur J Surg Oncol. 2014 Apr;40(4):379-86
pubmed: 24462547
HPB (Oxford). 2015 Apr;17(4):311-7
pubmed: 25298015
Nature. 2013 Jul 4;499(7456):43-9
pubmed: 23792563
J Clin Oncol. 2016 Sep 20;34(27):3267-75
pubmed: 27325852
J Surg Oncol. 2014 Jan;109(1):28-30
pubmed: 24122337
Medicine (Baltimore). 2018 Oct;97(42):e12653
pubmed: 30334949
Semin Oncol Nurs. 2017 Nov;33(4):440-448
pubmed: 28927761
Int J Surg. 2016 Dec;36(Pt A):319-323
pubmed: 27770639
Nat Rev Nephrol. 2017 Aug;13(8):496-511
pubmed: 28691713
Cancer Res Treat. 2016 Jul;48(3):1092-101
pubmed: 26875203