F06Outcome of patients with pancreatic metastases from renal cell carcinoma: when the site matters

Background: Pancreatic metastases from renal cell carcinoma (PmRCC) are uncommon and their prognostic value in the era of targeted terapies (TTs) is not well defined. We evaluated the outcome of a cohort of PmRCC patients (pts) who were treated with either surgery and TTs Patients and methods: PmRCC pts treated between 1993 and 2014 were identified from the databases of 11 European centers. Clinical records were retrospectively reviewed and pts characteristics including demographics and clinical outcome were analyzed. Kaplan-Meier methods and log-rank test were used to evaluate progression-free survival (PFS) and overall survival (OS). Cox's proportional hazard models were used to analyse covariates associated to OS Results: A total of 276 pts were evaluated. Median age was 62 years (range 26-82), sex ratio male/female was 179/97 and PmRCC were synchronous to the primary in 80 pts (29%). Pts treated with pancreatic surgery (including radiosurgery) were 77 (28%) while patients receiving systemic treatment were 256(93%). Pts with only PmRCC were 42 (15%) whereas in the other 234 cases: lung (47%), lymphnodes (28%) and liver (23%) were the most common metastatic sites. The majority of pts (95%) received nephrectomy (Nx). Median time from Nx to PmRCC occurrence was 91 months (IQR 54-142). First-line TTs included: sunitinib (44%), sorafenib (12%), pazopanib (9%), interferon + bevacizumab (6%) and temsirolimus (1%), 37% of pts received cytokines and 53% of pts received subsequent lines of TTs. Best response to first-line treatment were complete response (5%) partial response (40%) and stable disease (39%) with a disease control rate (DCR) of 84% and a median PFS of 12 months (IQR 10-14). Median OS (calculated from the time of PmRCC occurrence to death) was 73 months (IQR 61-86) with a 5-yr OS of 58%. Median OS for pts treated with local treatment to the pancreas was 106 months (IQR 78-204) with a 5-yr OS of 75%. At univariate analysis Motzer/Heng prognostic score (p = .0004), Nx (p = .0002) and local treatment (p = < .0001) were significantly associated with OS. At multivariate analysis these variables confirmed their prognostic role. Conclusions: PmRCC are associated with long-term survival, usually occur many years after Nx and lead to a less aggressive disease. Surgery should be considered in oligometastatic disease as it can be associated with prolonged survival. TTs are active in these pts and achieve high DCR.