BackgroundRenal cell carcinoma (RCC) is the most common renal malignancy, and may metastasize to different sites in the body via hematogenous and lymphomatous routes. The pancreas is a rare metastatic site of metastatic RCC (mRCC) and isolated pancreatic metastasis of RCC (isPMRCC) is even rarer.ResultsThe present report describes a case of isPMRCC that recurred 16 years after surgery. The patient responded well to the treatment with pancreaticoduodenectomy and systemic therapy, and no recurrence was recorded after 2 years.ConclusionsisPMRCC is a distinct subgroup of RCC with unique clinical characteristics that may be explained by its underlying molecular mechanisms. Surgery and systemic therapy confer survival benefits to patients with isPMRCCs, although the recurrence problem has to be paid attention to.

Background. According to American Joint Committee on Cancer (AJCC) 8th staging system, T1 intrahepatic cholangiocarcinoma (T1 ICC) is considered a tumor with no vascular invasion. However, T1 ICC usually occurs distant metastasis (DM), and the clinical features of these patients could help clinicians identify the high-risk population. Methods. We reviewed 1959 newly diagnosed patients with T1 ICC from the Surveillance, Epidemiology, and End Results (SEER) database during 2004–2018. Logistic regression models and Cox proportional hazards models were conducted to predict the risk of DM and overall survival (OS), respectively, and then, web-based nomograms were constructed. Decision curve analysis (DCA) and clinical impact curves (CIC) were used to measure the clinical utility of the models. The low-, medium-, and high-risk groups were identified by calculating the summary of the risk points. Nomograms on the web were also created to help clinicians better use these prediction models. Results. Tumor size and lymph node metastasis accounted for the first two largest proportions among the DM nomogram scores, while surgery, DM, age at diagnosis, chemotherapy, and lymph node metastasis occupied the largest percentage in OS nomogram. DM nomogram was established for these newly diagnosed patients with T1 ICC, and OS nomogram was developed to visually predict the OS rate of 3, 5, and 10 years. The calibration curves revealed a valid predictive accuracy of nomograms, of which the C-index was 0.703 and 0.740, respectively, for good discrimination. DCAs, CICs, and risk subgroups showed the clinical validity of these nomograms. Two websites were created to make it easier to use these nomograms. Conclusions. Novel web-based nomograms predicting the risk of DM and OS for T1 ICC were constructed. These predictive tools might help clinicians make precise clinical strategies for each patient with T1 ICC.

With the further expansion of China's "Belt and Road" initiative, the Chinese enterprises are being more and more active in the overseas market in recent years. Take the power industry for example, large number of Chinese engineering companies have developed their own systematic construction framework for different type of projects in domestic market. But challenges and problems may occur once the present domestic mode is directly applied to the international projects. And it also is the main uncertainty or risk faced by the Chinese enterprises when carrying out the international projects at present stage. Under this background, this paper takes the international electric power project under EPC mode (Engineering, Procurement and Construction) as the research object and the Interpretation Structure Model (ISM) is applied to analyze the potential risk factors which may affect the economic benefit and the social benefit during the implementation of these projects by Chinese enterprise. Through carrying out the comprehensive identification of those potential risk factors, this paper aims at providing a more visualized structure to show all kinds of potential risks and their corresponding impact mechanism for the Chinese contractors, which can reduce the risk level or the potential damages effectively when carrying out the related projects in overseas markets.