Pancreatic metastases from renal cell carcinoma: The state of the art

Table 1 Studies of renal cell cancer that include more than five patients

Ref.	Yr	n	5-yr survival	Median survival
Butturini et al[56]	1998	5	NR	24.5 mo
La Borgne et al[15]	2000	5	0%	35.5 mo
Kassabian et al[11]	2000	5	67%	Not reached
Ghavamian et al[59]	2000	11	81%	120 mo
Hioits et al[14]	2001	10	NR	4-8 yr
Faure et al[21]	2001	9	88%	Not reached
Law et al[22]	2003	14	75%	Not reached
Wente et al[27]	2005	15	NR	Not reached
Kohler et al[61]	2006	5	100%	Not reached
Crippa et al[10]	2006	5	80%	Not reached
Eidit et al[57]	2007	7	88%	Not reached
Varker et al[60]	2007	5	NR	Not reached
Bahra et al[55]	2007	9	100%	Not reached
Zerbi et al[12]	2008	23	88%	Not reached
Reddy et al[54]	2008	21	45%	58 mo
Tanis et al[63]	2009	10	NR	Not reached
Masetti et al[35]	2010	6	NR	Not reached
Konstantinidis et al[62]	2010	20	61%	8.7 yr

NR: Data not reported. Survival data is from the time of resection of the pancreatic metastasis, not from diagnosis of the primary tumor.

Table 2 Prognostic factors for risk group stratification model[70]

Factors for risk group	Poor prognostic category and factors
Factor	Category
Time from diagnosis to study entry	< 12 mo
Hemoglobin	Below lower limit of reference range
Lactate dehydrogenase	> 1.5 x upper limit of reference range
Corrected serum calcium	> 10.0 mg/dL
Previous radiotherapy	Yes
No. of metastatic sites	≥ 2
Risk Group	No. of factors
Favorable	Zero or one
Intermediate	Two
Poor	Three or more

Patients are stratified into three groups depending on the number of poor prognostic factors found, as follows: favorable risk group, patients with zero or one poor prognostic factor; intermediate risk group, presence of two poor prognostic factors; poor risk group, presence of three or more poor prognostic factors.

Table 3 Therapeutic algorithm

Patients with clear cell renal carcinoma		First-line therapy	Second-line therapy
Without previous treatment	Prognostic grade: favorable or intermediate prognosis	Sunitinib or	IL-2 high dose or
		Bevacizumab + interferon α	clinical trial
	Prognostic grade: poor	Temsirolimus	Sunitinib or
			clinical trial
With previous treatment	With cytokine	Sorafenib	Sunitinib
	With multitargeted therapy	Everolimus	Tyrosine kinase inhibitor or clinical trial
Patients with not clear cell renal carcinoma		Temsirolimus	Sunitinib or
			sorafenib