410 Survival Outcomes in Pancreatic Metastases from Renal Cell Carcinoma: A Systematic Review

Abstract Aim Renal cell carcinoma (RCC) is the most common cause of pancreatic metastases and can occur years after initial treatment of the primary site. Metastatic RCC has a heterogenous prognosis with pancreatic metastases having a relatively more favourable survival outcome compared to other organ metastases. Recent advances in systemic therapies may provide alternative treatment strategies for these patients. The optimal treatment approach for RCC pancreatic metastases has yet to be determined. Method Using PRISMA guidelines, databases including: Embase, Pubmed and Cochrane were searched as part of this systematic review to include patients who have undergone surgical, pharmacotherapy or conservative management of pancreatic metastases. The primary outcome measure was the median overall survival or 1 year overall survival from the day of metastectomy or initiation of systemic therapy. Results A total of 27 studies were identified which included a total of 2831 patients. The overall median survival range across four management cohorts included surgical only (39 - 75 months, n = 159), surgery +/- pharmacotherapy (30 - 135 months, n = 1072), pharmacotherapy alone (27 - 80 months, n = 304) and conservative (31 - 45 months, n = 83). In all cases, nephrectomy was performed as part of primary RCC management. Conclusions: Overall patients who are fit would likely benefit from surgical intervention for improved survival outcomes and additional systemic therapy should be offered on a case-by-case basis. Future practice would benefit from studies reporting survival outcomes for pharmacotherapy management for those otherwise managed conservatively.