Gastric and esophageal metastases in renal cell carcinoma: systematic review and management options

Abstract

Renal cell cancer (RCC) has been rarely reported as a cause of gastric (GM) or esophageal metastases (EM). The aim of this review was to study the clinical characteristics, management, and outcome of GM and EM in RCC. A systematic review of the literature was conducted by searching four major online databases. Sixty-eight cases were identified: 64 with GM, and 6 with EM (2 had coincident GM and EM). GM presented more often with anemia and gastrointestinal bleeding, were more frequent in the body or fundus, and used to be single. Median interval from diagnosis of RCC to GM (IGM) was 54 months (range 0–288). Cases reported after year 2004 demonstrate an increasing tendency to use endoscopic resections and to perform less aggressive surgical procedures for GM. Bleeding (p = 0.009), melena (p = 0.024), and an IGM ≤ 54 months (p = 0.055) occurred more often in women. Both larger GM (p = 0.015) and a shorter IGM (p = 0.004) were more frequent when there were metastases in other organs. We report the largest review to date on GM and EM in RCC, and we show the increasing tendency to use less aggressive treatments for GM in the last decade. Female sex may be a risk factor for bleeding of GM. Female sex, larger GM and a shorter IGM, may be associated with a more aggressive disease in RCC. The possible treatment options for these rare entities are also discussed.