Z Gastroenterol 2025; 63(08): e505-e506
DOI: 10.1055/s-0045-1810879
Abstracts | DGVS/DGAV
Kurzvorträge
Pankreaschirurgie Donnerstag, 18. September 2025, 17:10 – 18:30, Vortragsraum 10

Exceptional survival after pancreatic metastasectomy in renal cell carcinoma across two decades

F Sonntag
1   Universitätsklinikum Heidelberg – Allgemein-, Viszeral- und Transplantationschirurgie, Heidelberg, Deutschland
,
M C Kryschi
1   Universitätsklinikum Heidelberg – Allgemein-, Viszeral- und Transplantationschirurgie, Heidelberg, Deutschland
,
T Hank
1   Universitätsklinikum Heidelberg – Allgemein-, Viszeral- und Transplantationschirurgie, Heidelberg, Deutschland
,
C W Michalski
1   Universitätsklinikum Heidelberg – Allgemein-, Viszeral- und Transplantationschirurgie, Heidelberg, Deutschland
,
M Loos
1   Universitätsklinikum Heidelberg – Allgemein-, Viszeral- und Transplantationschirurgie, Heidelberg, Deutschland
,
M W Büchler
2   Botton-Champalimaud Pancreatic Cancer Centre, Lisboa, Portugal
,
S Roth
3   Universitätsklinik Tübingen – Allgemein-, Viszeral- und Transplantationschirurgie, Tübingen, Deutschland
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    Introduction: Metastases account for approximately 2-5% of all malignant pancreatic tumors, with renal cell carcinoma (RCC) comprising nearly two-thirds of these cases. The role of surgical resection for RCC metastases to the pancreas remains controversial.

    Aims: This retrospective, single-center study assesses long-term outcomes following pancreatic surgery for RCC metastases to evaluate the potential benefit of an aggressive surgical approach.

    Methods: We conducted a retrospective analysis from a prospective database. Patient demographics, primary tumor characteristics, surgical procedures, complications, and survival outcomes were collected.

    Results: A total of 118 patients underwent pancreatic resection for metastatic RCC between October 2001 and June 2023. Surgical approaches included pancreatic enucleation (n=1), distal pancreatectomy (n=46), segmentectomy (n=5), total pancreatectomy (n=40), extended distal pancreatectomy (n=3), pylorus-preserving pancreaticoduodenectomy (n=16), and pylorus-resecting Whipple procedure (n=7). Resection of the remnant pancreas was subsequently performed in 9 patients due to recurrent disease. The median age at surgery was 65.5 (47.0-87.0) years, with 43 (36.4%) female patients. No postoperative complications were observed in 55 (46.6%) patients, 37 (31.4%) experienced minor complications (≤Clavien-Dindo IIIA) and 26 (22.0%) patients had major complications (>Clavien-Dindo IIIB). The overall perioperative mortality was 7.6% (n=9). Median survival after initial nephrectomy was 292.9 months, while median survival following pancreatic surgery was 137.1 months. For the 9 patients who underwent repeat pancreatic surgery for recurrent disease, median survival reached 86.4 months after the second procedure.

    Conclusion: Pancreatic resection for RCC metastases is associated with exceptional long-term survival in selected patients. Our results suggest that an aggressive surgical approach is warranted tailored to the location and extent of metastatic disease. The exceptional median survival exceeding 11 years following pancreatic metastasectomy supports the role of surgery in this context.


     

    Publication History

    Article published online:
    04 September 2025

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