Surgical Treatment of Pancreatic RCC Metastases

NCT ID: NCT03670992

Last Updated: 2018-09-14

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

26 participants

Study Classification

OBSERVATIONAL

Study Start Date

2016-01-10

Study Completion Date

2017-01-10

Brief Summary

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Data from 26 patients undergoing resection of Pancreatic Metastases and extra-Pancreatic Metastases from RCC were retrospectively analysed. Clinical data were collected from a digital database and QoL was assessed through patient's interview and Karnofsky performance scale.

Detailed Description

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Retrospective data was analysed from 26 patients that were submitted to pancreatic resection between August 2002 and November 2015. Inclusion criteria were: single or multiple metastases in pancreas or extra pancreatic; primary RCC; never received chemotherapic treatment; patients that already received a previous pancreatic resection were also included.

Cases were collected from two high-volume centres: Surgical Department "Pietro Valdoni" in Policlinico Umberto I and the Division of Transplantation and General Surgery at University of Pisa.

Different kind of surgical approaches were taken into account in this study: duodenal-pancreatectomy, total-pancreatectomy and distal-pancreatectomy associated or not with other metastatic site resections. Surgery was performed either with classical open approach and modern robotic surgical approach, with the robot "Da Vinci". Aim of surgical interventions were to remove all metastases in association to radical lymphadenectomy thus to achieve R0 result. All postoperative events occurring within 90 days of surgery were considered. Postoperative complications were graded according to Clavien-Dindo classification.

Patients were followed-up 3 months after discharge and every 6 months thereafter.

Patients had blood chemistries and CT scans at least every year. A database was used to record all patients' data. Results were analysed in terms of Operative Mortality and Morbidity, Actuarial Survival, Actuarial Disease-Free Survival and Quality of Life.

Protocols were approved by the bioethical review committee and meet the guidelines of both University Sapienza of Rome and University of Pisa.

QoL was measured by Karnofsky performance scale and through Activities of Daily Living scale (ADL), Instrumental Activities of Daily living scale (IADL), BMI evaluation, serum albumin and hemoglobin, also depression was evaluated as a parameter. QoL was defined by combination of these parameters as: excellent, good, fair, poor or very poor.

A low Karnofsky scale index with inadequate social and environmental situations, a reduction in functional capacity with depression and severe weight-loss were identified as a decline in QoL.

Data was analysed via Chi-square test, as well as Student's paired and unpaired t-tests.

Actuarial relative survival and actuarial relative disease-free survival were described by Kaplan-Meier analysis. A log-rank test was used to compare continuous variables and was expressed by Kaplan-Meier curves. Homogeneity of the different groups to be compared was tested by chi-square test. Statistical significance was set at p ≤ 0,05.

Conditions

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Renal Cell Carcinoma Metastases, Neoplasm

Study Design

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Observational Model Type

CASE_ONLY

Study Time Perspective

RETROSPECTIVE

Study Groups

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Pancreatic Metastases

Patients with only pancreatic metastases from RCC

duodenal-pancreatectomy

Intervention Type PROCEDURE

surgical removal of metastatic repetitions in pancreas and/or other distal sites

extra-pancreatic metastases

patients with extra pancreatic metastases from RCC

duodenal-pancreatectomy

Intervention Type PROCEDURE

surgical removal of metastatic repetitions in pancreas and/or other distal sites

Interventions

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duodenal-pancreatectomy

surgical removal of metastatic repetitions in pancreas and/or other distal sites

Intervention Type PROCEDURE

Other Intervention Names

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total-pancreatectomy distal-pancreatectomy other metastases resection

Eligibility Criteria

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Inclusion Criteria

* metastases from RCC
* surgically manageable lesions

Exclusion Criteria

* metastases from different malignancies
* other malignancies
* surgically unmanageable
Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Azienda Policlinico Umberto I

OTHER

Sponsor Role lead

Responsible Party

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Professor Stefania Brozzetti

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Stefania Brozzetti, professor

Role: STUDY_DIRECTOR

Policlinico Umberto I

Locations

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Department of Surgery "Pietro Valdoni"

Roma, , Italy

Site Status

Countries

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Italy

References

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Adler H, Redmond CE, Heneghan HM, Swan N, Maguire D, Traynor O, Hoti E, Geoghegan JG, Conlon KC. Pancreatectomy for metastatic disease: a systematic review. Eur J Surg Oncol. 2014 Apr;40(4):379-86. doi: 10.1016/j.ejso.2013.12.022. Epub 2014 Jan 15.

Reference Type RESULT
PMID: 24462547 (View on PubMed)

Tanis PJ, van der Gaag NA, Busch OR, van Gulik TM, Gouma DJ. Systematic review of pancreatic surgery for metastatic renal cell carcinoma. Br J Surg. 2009 Jun;96(6):579-92. doi: 10.1002/bjs.6606.

Reference Type RESULT
PMID: 19434703 (View on PubMed)

Grassi P, Doucet L, Giglione P, Grunwald V, Melichar B, Galli L, De Giorgi U, Sabbatini R, Ortega C, Santoni M, Bamias A, Verzoni E, Derosa L, Studentova H, Pacifici M, Coppa J, Mazzaferro V, de Braud F, Porta C, Escudier B, Procopio G. Clinical Impact of Pancreatic Metastases from Renal Cell Carcinoma: A Multicenter Retrospective Analysis. PLoS One. 2016 Apr 11;11(4):e0151662. doi: 10.1371/journal.pone.0151662. eCollection 2016.

Reference Type RESULT
PMID: 27064898 (View on PubMed)

Fikatas P, Klein F, Andreou A, Schmuck RB, Pratschke J, Bahra M. Long-term Survival After Surgical Treatment of Renal Cell Carcinoma Metastasis Within the Pancreas. Anticancer Res. 2016 Aug;36(8):4273-8.

Reference Type RESULT
PMID: 27466543 (View on PubMed)

Brozzetti S, Bini S, De Lio N, Lombardo C, Boggi U. Surgical-only treatment of pancreatic and extra-pancreatic metastases from renal cell carcinoma - quality of life and survival analysis. BMC Surg. 2020 May 13;20(1):101. doi: 10.1186/s12893-020-00757-0.

Reference Type DERIVED
PMID: 32404091 (View on PubMed)

Other Identifiers

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PAN001

Identifier Type: -

Identifier Source: org_study_id

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