HPB : the official journal of the International Hepato Pancreato Biliary Association · 2026
Pancreatic resection for metastatic renal cell carcinoma: outcomes in the era of immunotherapy and targeted therapy.
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Muaddi Hala, Li-Han Leo, Costello Brian A, Boorjian Stephen A, Sharma Vidit, Leibovich Bradley C, Truty Mark, Kendrick Michael, Thiels Cornelius A
Аннотация
INTRODUCTION: Pancreatic metastases from renal cell carcinoma (RCC) are rare and the role of pancreatectomy in the era of immunotherapy and targeted therapies remains unclear. This study evaluated outcomes following pancreatic resection for RCC metastases in the modern treatment era.
METHODS: Patients with RCC who developed pancreatic metastases and underwent pancreatectomy were retrospectively reviewed. Patients were stratified by immunotherapy use, disease distribution (isolated pancreatic vs. multi-site), and number of lesions (single vs. multiple). Recurrence rate (RR) and overall survival (OS) were estimated using Kaplan-Meier analysis.
RESULTS: Sixty-two patients were included (median age 67 years; 35.5% female). Isolated pancreatic metastases were present in 51.6%, and 64.5% had a solitary pancreatic lesion. Because immunotherapy was predominantly initiated after recurrence, RR at 1, 3, and 5 years was higher among treated patients (37%, 66%, 88%) compared with those not receiving immunotherapy (16%, 34%, 54%; p = 0.006). Despite this, OS remained comparable between groups (p = 0.53). Patients with isolated pancreatic metastases had lower 5-year recurrence rates than those with multi-site metastases (60% vs. 89%; p = 0.007), although OS did not differ. Lesion number did not impact RR or OS.
CONCLUSION: Pancreatectomy for RCC metastases is associated with good OS and remains a strategy, including as a means to defer immunotherapy.
METHODS: Patients with RCC who developed pancreatic metastases and underwent pancreatectomy were retrospectively reviewed. Patients were stratified by immunotherapy use, disease distribution (isolated pancreatic vs. multi-site), and number of lesions (single vs. multiple). Recurrence rate (RR) and overall survival (OS) were estimated using Kaplan-Meier analysis.
RESULTS: Sixty-two patients were included (median age 67 years; 35.5% female). Isolated pancreatic metastases were present in 51.6%, and 64.5% had a solitary pancreatic lesion. Because immunotherapy was predominantly initiated after recurrence, RR at 1, 3, and 5 years was higher among treated patients (37%, 66%, 88%) compared with those not receiving immunotherapy (16%, 34%, 54%; p = 0.006). Despite this, OS remained comparable between groups (p = 0.53). Patients with isolated pancreatic metastases had lower 5-year recurrence rates than those with multi-site metastases (60% vs. 89%; p = 0.007), although OS did not differ. Lesion number did not impact RR or OS.
CONCLUSION: Pancreatectomy for RCC metastases is associated with good OS and remains a strategy, including as a means to defer immunotherapy.