Pancreatic resection for renal cell carcinoma metastasis: a case review.

Renal cell carcinoma (RCC) is the most common type of kidney malignancy. The pancreas is an infrequent site of metastasis in relation to any type of malignancy. However, RCC is one of the tumor types that most frequently metastasize to the pancreas. In this study, we report our experiences with two patients who underwent pancreatic resection for metastatic RCC tumors; of these two patients, one patient had a tumor was a metachronous pancreas-only tumor, and the other patient's tumor was synchronous with hematogenous lung metastasis. Following left-side pancreatic resection, the patients were administered tyrosine kinase inhibitors.

Long-term results of extended intersphincteric resection for very low rectal cancer: a retrospective study.

BACKGROUND: Intersphincteric resection (ISR) has become an increasingly popular optional surgical tool for the treatment of very low rectal cancer. The purpose of this study was to assess the long-term oncological and functional outcomes of intersphincteric resection for T2 and T3 rectal cancer situated below 4 cm from the anal verge. METHODS: A total of 62 consecutive patients with very low rectal cancer who underwent ISR from 2001 to 2010 were classified into standard ISR for T2 lesions (Group I, n = 24) and extended ISR for T3 lesions (Group II, n = 38). RESULTS: The 5-year overall survival rates were 95.8% for group I and 94.7% for group II. The 5-year recurrence-free survival rates were 87.5% for group I and 86.8% for group II. Bowel functions were evaluated at the 12(th) and 24(th) months after ileostomy closure in both groups. The frequency of bowel evacuation was higher in patients who underwent extended ISR than in those who underwent standard ISR at the 12(th) month (p < 0.05). However, at the 24(th) month, the frequencies decreased in both groups, exhibiting no significant difference. In the comparison based on the Kirwan classification, group I showed better continence status than group II but no significant difference. The Wexner scores of both groups revealed that the average score was 7.33 ± 2.8 in group I and 8.18 ± 2.9 in group II at the 12(th) month, and at the 24(th) month, the average score was 5.21 ± 1.7 in group I and 5.82 ± 1.9 in group II. There were no statistically significant differences between the two groups. CONCLUSIONS: Extended ISR with quadrant resection of the upper external sphincter achieved good post-operative continence status, OS and RFS. Extended ISR can thus be an alternative to abdominoperineal resection for very low rectal cancer without compromising the chance of cure and improving quality of life.

Comparative analysis of radiofrequency ablation and resection for resectable colorectal liver metastases.

AIM: To evaluate the therapeutic efficacy of radiofrequency ablation (RFA) for resectable colorectal liver metastases (CRLM) compared with that of resection. METHODS: Between June 2004 and June 2009, we retrospectively analyzed 29 patients with resectable CRLMs; 17 patients underwent RFA, and 12 underwent hepatic resection. All of the patients were informed about the treatment modalities and were allowed to choose either of them. RFA including an intraoperative approach was performed by a radiologist; otherwise, hepatic resection was performed by a surgeon. Comparative analysis of the two groups was performed, including comparisons of gender, age, and clinical outcomes, such as primary tumor stage and survival rates. RESULTS: The mean tumor size was significantly larger in the resection group (3.59 cm vs 2.02 cm, P < 0.01), and the 5-year overall survival (OS) rate for all patients was 44.7%. There was no difference in the 5-year OS rates between the RFA and resection groups (37.8% vs 66.7%). Univariate analysis indicated significantly lower 5-year OS rates for patients with a tumor size > 3 cm. The 5-year disease-free survival (DFS) rates were 17.6% and 22.2% in the RFA and resection groups, respectively (P = 0.119). Univariate analysis revealed that in cases of male gender, age > 65 years, T stage < IV, absence of lymphatic metastasis, and tumor size > 3 cm, RFA resulted in significantly inferior 5-year DFS rates compared with surgical resection. CONCLUSION: Surgical resection revealed superior outcomes in the treatment of resectable CRLMs, particularly in cases with a hepatic tumor size > 3 cm.