Long-term Outcomes after Laparoscopic Distal Pancreatectomy for Renal Cell Carcinoma Metastasis in the Pancreas: A Single-Center Experience

Background: The aim of this study was to foster evidence, favoring laparoscopic distal pancreatectomy as a safe, patient friendly procedure, significantly prolonging survival in patients with metastases from renal cell carcinoma (RCC) to the pancreas. Laparoscopic distal pancreatectomy (LDP) is becoming a standard of care for lesions in the body and tail of the pancreas. Yet its role in the treatment of renal cell carcinoma (RCC) metastases to the pancreas remains unclear. Methods: From May 2002 to November 2021, perioperative and long-term oncological outcomes were recorded prospectively in 21 patients undergoing distal pancreatectomy resection for RCC metastases at Oslo University Hospital. Results: In 21 resections, 17 (81 %) were performed laparoscopically, four by open surgical technique. Median follow-up was 59(19-136) months. Recurrence was detected in 12 (57.1%). Median recurrence-free survival was 51 months, while 3- and 5-year recurrence-free were 58.3 and 38.9 %, respectively. Overall survival at 3 and 5 years were 89.7 % and 72.1%, respectively. No significant differences were observed between the patients undergoing laparoscopic and open surgery. Conclusion: Distal pancreatectomy for pancreatic metastases from RCC is associated with acceptable oncologic outcomes. LDP is a feasible and safe alternative to open approach. Careful selection in a multidisciplinary setting remains crucial.