Systematic review and metanalysis of clinical outcomes after enucleation of pancreatic metastases from renal cell carcinoma

Introduction: A systematic review of the literature was carried out to determine the clinical and oncological outcome of patients who had enucleation of solitary pancreatic metastases from renal cell carcinoma. Methods: Operative mortality, postoperative complications, observed survival and disease free survival were analyzed. The clinical outcomes of patients who had enucleation were compared to those of 857 patients collected from the literature who had standard or atypical pancreatic resection for the same disease using propensity score matching Results: There was no postoperative mortality in the 56 patients who had enucleation of pancreatic metastases from renal cell carcinoma . In 51 patients postoperative complications could be analyzed. Ten patients (10/51=19.6%) had postoperative complications. Three patients (3/51 = 5.9%) had major complications (Clavien-Dindo III or more). Five year observed survival rates and disease free survival for patients with enucleation were 92% and 79% respectively. These results compared favourably with those obtained in patients who had standard resection and other forms of atypical resection (also using propensity score matching). Patients who had partial pancreatic resection (atypical or not) with pancreatic-jejunal anastomosis had increased rates of postoperative complications and local recurrences. Conclusions: Enucleation of pancreatic metastases offers a valid solution in selected patients.