Introduction
Methods
Results
Renal cell carcinoma vs. other tumor entities
Parameter | All (n = 29) | mRCC (n = 20) | mnRCC (n = 9) | p |
---|---|---|---|---|
Sex [n (%)] | ♀13 (45%) | ♀10 (50%) | ♀3 (33%) | NS |
♂16 (55%) | ♂10 (50%) | ♂6 (67%) | ||
Age [years, median (range)] | 66 (44–79) | 68 (53–78) | 63 (45–74) | 0.02 |
ASA-Score [n (%)] | NS | |||
I | 0 (0%) | 0 (0%) | 0 (0%) | |
II | 17 (59%) | 10 (50%) | 7 (78%) | |
III | 11 (38%) | 9 (45%) | 2 (22%) | |
IV | 1 (3%) | 1 (5%) | 0 | |
BMI [kg/m2, median (range)] | 28 (20–41) | 29 (20–41) | 23 (20–34) | NS |
Diabetes [n (%)] | 3 (10%) | 2 (10%) | 1 (11%) | NS |
Hypertension [n (%)] | 14 (48%) | 12 (60%) | 2 (22%) | 0.02 |
CHD [n (%)] | 1 (3%) | 0 (0%) | 1 (11%) | NS |
Pulmonary disease [n (%)] | 10 (34%) | 7 (35%) | 3 (33%) | NS |
Renal disease [n (%)] | 17 (59%) | 16 (80%) | 1 (11%) | 0.002 |
Postoperative mortality [n (%)] | 2 (7%) | 2 (10%) | 0 (0%) | NS |
Disease-free survival [months, median (range)]+ | 14 (2–170) | 14 (2–150) | 22 (4–170) | NS |
Time from primary tumor to metastasis [months, median (range)] | 89 (6–331) | 116 (6–331) | 66 (13–108) | 0.07 |
Metachronous diagnosis [n (%)] | 28 (97%) | 20 (100%) | 8 (89%) | NS |
5-year survival rate [n (%)]* | 22 (82%) | 16 (89%) | 6 (67%) | NS |
Overall survival rate [n (%)]* | 19 (70%) | 14 (78%) | 5 (56%) | NS |
Parameter | All (n = 29) | mRCC (n = 20) | mnRCC (n = 9) | p |
---|---|---|---|---|
Localization of tumor [n (%)] | NS | |||
Head | 6 (21%) | 3 (15%) | 3 (33%) | |
Body | 6 (21%) | 3 (15%) | 3 (33%) | |
Tail | 8 (28%) | 5 (25%) | 3 (33%) | |
More than one localization | 9 (31%) | 9 (45%) | 0 (0%) | |
Advance of disease [n (%)] | NS | |||
Single metastasis | 17 (59%) | 8 (40%) | 9 (100%) | |
Further pancreatic metastasis | 12 (41%) | 12 (60%) | 0 (0%) | |
Extra-pancreatic metastasis | 13 (45%) | 8 (40%) | 5 (56%) | |
Past extra-pancreatic metastasis | 19 (65%) | 12 (60%) | 7 (78%) | |
Tumor size [mm, median (range)] | 21 (4–60) | 19 (4–50) | 32 (18–60) | NS |
Initial tumor stage | NS | |||
T1 | 8 (27%) | 7 (35%) | 1 (11%) | |
T2 | 4 (14%) | 3 (15%) | 1 (11%) | |
T3 | 6 (21%) | 3 (15%) | 3 (33%) | |
TX | 11 (38%) | 7 (35%) | 4 (45%) | |
Initial lymph node stage | NS | |||
N0 | 15 (52%) | 11 (55%) | 4 (44%) | |
N1 | 1 (3%) | 0 (0%) | 1 (12%) | |
NX | 13 (45%) | 9 (45%) | 4 (44%) | |
Symptoms [n (%)] | NS | |||
Pain | 2 (7%) | 1 (5%) | 1 (11%) | |
Jaundice | 1 (3%) | 1 (5%) | 0 (0%) | |
Diagnostic method [n (%)] | 0.014 | |||
CT | 18 (62%) | 15 (75%) | 3 (33%) | |
MRI | 13 (45%) | 10 (50%) | 3 (33%) | |
CT and MRI | 6 (21%) | 5 (25%) | 1 (11%) | |
PET-CT | 14 (48%) | 8 (40%) | 6 (67%) | |
Diagnostic sensitivity | n/a | |||
CT | 89% | 93% | 67% | |
MRI | 92% | 90% | 100% | |
PET-CT | 71% | 50% | 100% |
Parameter | All (n = 29) | mRCC (n = 20) | mnRCC (n = 9) | p |
---|---|---|---|---|
Surgical approach [n (%)] | NS | |||
Pancreatic head resection | 6 (21%) | 3 (15%) | 3 (33%) | |
Distal pancreatectomy | 17 (59%) | 11 (55%) | 6 (67%) | |
Pancreatectomy | 6 (21%) | 6 (30%) | 0 (0%) | |
Resection [n (%)] | NS | |||
R0 | 25 (87%) | 17 (85%) | 8 (89%) | |
R1 | 3 (10%) | 3 (15%) | 0 (0%) | |
R2 | 0 (0%) | 0 (0%) | 0 (0%) | |
Rx | 1 (3%) | 0 (0%) | 1 (11%) | |
Perioperative blood transfusion [n (%)] | 4 (14%) | 4 (20%) | 0 | NS |
Operative time [min, median (range)] | 281 (154–556) | 287 (154–556) | 266 (172–527) | NS |
ICU stay [days, median (range)] | 4 (1–45) | 5 (2–35) | 3 (1–45) | NS |
Hospital stay [days, median (range)] | 18 (8–99) | 19(11–699) | 13 (8–28) | NS |
Postoperative complications*[n (%)] | ||||
Overall | 21 (72%) | 14 (70%) | 7 (78%) | NS |
2 | 12 (52%) | 8 (40%) | 4 (45%) | |
3 | 5 (17%) | 2 (10%) | 3 (33%) | |
4 | 2 (7%) | 2 (10%) | 0 (0%) | |
5 | 2 (7%) | 2 (10%) | 0 (0%) | |
POPF [n (%)]+ | NS | |||
BL | 3 (13%) | 2 (14%) | 1 (11%) | |
B | 11 (48%) | 7 (50%) | 4 (44%) | |
C | 3 (13%) | 2 (14%) | 1 (11%) | |
DGE [n (%)] | ||||
A | 5 (17%) | 3 (15%) | 2 (22%) | NS |
B | 3 (10%) | 3 (15%) | 0 (0%) | |
PPH [n (%)] | 4 (14%) | 2 (10%) | 2 (22%) | NS |
Relaparotomy [n (%)] | 5 (17%) | 4 (20%) | 1 (11%) | NS |
Intervention [n (%)] | 8 (28%) | 6 (30%) | 2 (22%) | NS |
Pat. # | Sex, age (years) | Primary tumor | Therapy of primary tumor | Previous metastasis | Therapy of previous metastasis | time until pancreas metastasis | Simultaneous extrapancreatic metastasis | Number and localization in pancreas | Pancreas resection | Therapy of simultaneous extrapancreatic metastasis | Recurrence | Further oncological course | Survival (month) |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1 | m, 67 | RCC, L | Nephrectomy | No | – | 73 | No | 2, multiple | DP | – | No | No | 26 |
2 | m, 79 | RCC, L | Nephrectomy | No | – | 331 | No | 4, tail | DP | – | – | – | – |
3 | m, 59 | RCC, R | Nephrectomy | No | – | 179 | Adrenal gland L | 1, tail | DP | Resection later | Adrenal gland R, supraclavicular | Surgery 2x, RTx3x Sunitinib, Axitinib | 47 |
4 | m, 44 | NET | No | No | – | – | No | 1, head | PD | – | No | No | 52 |
5 | m, 66 | RCC, L | Nephrectomy | Kidney R | RFA | 16 | Kidney R | 1, tail | DP | RTx | Kidney R | RTx | 34 |
6 | f, 51 | Melanoma | Excision, cervical LAD Interferon alpha | No | – | 13 | M. psoas | 1, tail | DP | Simultaneous resection | Multiple metastasis | RTx, Ipilimumab | 28 |
7 | m, 63 | Colon cancer | Resection | Liver | Resection | 28 | No | 1, head | PD | – | Lung | Surgery 3x | 70 |
8 | f, 59 | RCC, L | Nephrectomy | Kidney re | Organ preserving resektion | 252 | No | 1, tail | DP | – | Kidney re | RFA, organpreserving resection | 32 |
9 | f, 57 | RCC, R | Nephrectomy re | Lung, adrenal gland | Resection | 64 | M. psoas | 15, multiple | TP | Simultaneous resection | Lung | Sunitinib, Nivolumab, Cabozantinib | 33 |
10 | f, 77 | RCC, L | Nephrectomy | No | 173 | No | 3, multiple | DP | – | No | No | 12 | |
11 | m, 48 | Melanoma | Excision, interferon alfa | Lung, neck, schoulder | Resection, RTx, interferon alpha | 37 | No | 1, tail | DP | n.a | 28 | ||
12 | f, 70 | RCC, L | Nephrectomy | Kidney R, adrenal gland | Resection | 6 | Adrenal | 3, multiple | DP | Simultaneous resection | n.a | 102 | |
13 | f, 62 | RCC, R | Nephrectomy | No | – | 137 | No | 3, multiple | TP | M. obturatorius externus R, M. vastus medialis L | RTx, surgery 2x, Nivolumab | 94 | |
14 | m, 68 | RCC, R | Nephrectomy | Thyroid gland | Resection | 199 | Kidney | 1, head | PD | Organ preserving resection later | No | No | 103 |
15 | m, 75 | RCC, R | Nephrectomy | No | – | 177 | No | 4, multiple | TP | – | Bone, adrenal, kidney, lung | RTx | 24 |
16 | m, 45 | Melanoma | Excision, interferon alfa | Axilla | Resection interferon alpha | 75 | Cerebral, lung | 1, corpus | DP | LINAC–Radiosurgery, resection lung | Cerebral lung | RTx CTx | 41 |
17 | f, 75 | RCC, L | Nephrectomy | No | – | 76 | No | 1, tail | DP | – | Lung, bone | Sunitinib, Nivolumab, RTx | 25 |
18 | f, 69 | RCC, R | Neprectomy | Thyroid gland parotid gland | Resection | 194 | Lung | 3, corpus | PD | Resection later | Pancreas adrenal gland | Nivolumab | 156 |
19 | f, 61 | Ovarial cancer | Resection | Diaphragm, lymph nodes | CTx, Resection | 81 | Spleen, duodenum | 1, tail | DP | Simultaneous resection | Lymphnodes | CTx 4x | 42 |
20 | m, 72 | Colon cancer | Resection | Liver, lung | Resection | 108 | No | 1, corpus | DP | – | No | No | 170 |
21 | m, 53 | RCC, L | Nephrectomy | Lung, other kidney | Organ preserving resection | 156 | Kidney, adrenal bone, | 2, multiple | DP | Simultaneous resection, RTx later | Lung | No | 15 |
22 | f, 74 | Melanoma | Excision, Roferon | Axilla elbow, | Excision, RTx, Roferon, CTx | 62 | Chest wall | 1, head | PD | Resection later | Axilla, Epicondilus medialis L, chest wall | Resection 3x, CTx 6x Trametinib, Ixoten, Ipilimumab | 16 |
23 | m, 54 | RCC, R | Nephrectomy | Lung | Resection | 24 | No | 2, multiple | TP | – | Liver, lung | Sunitinib, CTx 5x | 76 |
24 | f, 66 | RCC, L | Nephrectomy | Thyroid gland | Resection | 96 | Renal bed | 5, corpus | DP | Simultaneous resection | Pancreas, kidney | Resection | 134 |
25 | f, 65 | RCC, L | Nephrectomy | Thyroid gland, pancreas | Resection | 96 | No | 1, head | TP | Lumbar spine, kidney re | Resection, RFA, Pembrolizumab, Axitinib | 148 | |
26 | m, 46 | Melanoma | Excision, Interferon alpha | Lymph nodes, bone, cerebral, abdominal wall, jejunum, adrenal | Resection, RTx, Chemotherapy | 70 | Ileum | 1, corpus | DP | Simultaneous resection | Multiple | Ipilimimab, resection 2x, RTx 5x Pembrolizumab, Mekinist | 62 |
27 | m, 69 | RCC, R | Nephrectomy | Lung, thyroid gland | Resection | 256 | No | 1, head | PD | – | Supraclaviculär | Resection | 67 |
28 | f, 78 | RCC, R | Nephrectomy | No | – | 168 | No | 1, corpus | DP | – | No | No | 102 |
29 | m, 73 | RCC, L | Organ preserving resection | Parotid gland | Resection | 19 | No | 3, multiple | TP | – | – | – | – |