Clinicopathological Features, Prognostic Factors and Survival in Patients With Pancreatic Cancer Bone Metastasis

Ren, Ying; Wang, Shicheng; Wu, Bo; Wang, Zhan

doi:10.3389/fonc.2022.759403

Cited by 10 publications

(9 citation statements)

References 42 publications

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“…As previously reported, the probabilities of peritoneal, liver, lung, bone, and brain metastases from pancreatic cancer were found to be 49.9%, 45.1%, 11.4%, 3.8%, 0.4%, respectively, which indicates that the liver is the most common organ for distant metastasis of PCa (4). Additionally, studies have shown that the prognosis of pancreatic cancer liver metastasis (PCLM) is worse than other distant metastases (5).…”

Section: Introductionmentioning

confidence: 59%

Risk factors and predictive nomograms for early death of patients with pancreatic cancer liver metastasis: A large cohort study based on the SEER database and Chinese population

et al. 2022

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BackgroundThe liver is the most common organ for distant metastasis of pancreatic cancer, and patients with pancreatic cancer liver metastases (PCLM) often die in a short period of time. As such, the establishment of an effective nomogram to predict the probability of early death (survival time ≤3 months) in PCLM patients is of considerable significance.MethodsPatients diagnosed with PCLM in the Surveillance, Epidemiology, and End Result (SEER) database between 2010 and 2015 were included for model construction and internal validation. A data set was obtained from the Chinese population for external validation. Risk factors that contributed to all-cause and cancer-specific early death were determined by means of univariable and multivariable logistic regression. The accuracy of the nomogram was verified by means of receiver operating characteristic (ROC) curves, and the true consistency of the model was assessed by calibration curves. The clinical applicability of the model was evaluated by means of decision curve analysis (DCA).ResultsA total of 12,955 patients were included in the present study, of whom 7,219 (55.7%) experienced early death and 6,973 (53.8%) patients died of PCLM. Through multivariable logistic regression analysis, 11 risk factors associated with all-cause early death and 12 risk factors associated with cancer-specific early death were identified. The area under the curves (AUCs) for all-cause and cancer-specific early death were 0.806 (95% CI: 0.785- 0.827) and 0.808 (95% CI: 0.787- 0.829), respectively. Internal validation showed that the C-indexes of all-cause and cancer-specific early death after bootstrapping (5,000 re-samplings) were 0.805 (95% CI: 0.784-0.826) and 0.807 (95% CI: 0.786-0.828), respectively. As revealed by the calibration curves, the constructed nomograms exhibited good consistency. The decision curve analysis (DCA) indicated the nomograms had significant clinical applicability.ConclusionIn the present study, reliable nomograms were developed for predicting the early death probability in patients with PCLM. Such tools can help clinicians identify high-risk patients and develop individualized treatment plans as early as possible.

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Section: Introductionmentioning

confidence: 59%

Risk factors and predictive nomograms for early death of patients with pancreatic cancer liver metastasis: A large cohort study based on the SEER database and Chinese population

et al. 2022

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“…In previous reports, lung metastasis was an independent poor prognostic factor for bone metastasis of PC. [13,14] A possible reason for this is that highly malignant bone metastasis had also spread to the lungs because some biomarkers, including IL-6, may be expressed at the same high levels in bone and lung metastases. [17,20] However, PC lung metastasis has been reported to have a better prognosis than liver metastasis or peritoneal dissemination.…”

Section: Discussionmentioning

confidence: 99%

“…[11,12] However, recent studies including population-based databases, such as the Surveillance, Epidemiology, and End Results database, have gradually clarified the characteristics of bone metastasis in PC. [3,[13][14][15][16] According to these studies, primary tumors of the pancreatic tail, compared to that of the pancreatic head, are more likely to develop bone metastases, [13] and the spine is the most common site of bone metastasis in patients with PC. [16] Based on the above results, in addition to the transarterial metastasis via the circulatory system, transvenous metastasis from the portal vein through the vertebral venous plexus may be involved in the mechanism of bone metastasis from PC.…”

Section: Discussionmentioning

confidence: 99%

Long-term survival after surgical resection for bone metastasis from pancreatic cancer: A case report

Hayashi,

Kitago,

Abe

et al. 2023

Medicine

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Introduction: Pancreatic cancer (PC) is highly malignant and metastatic; however, bone metastases are rare. Although the effectiveness of conversion surgery for distant metastases of PC has been reported in a few cases, there are no reports on surgical resection for bone metastases. Here, we report a case of long-term survival after resection of bone metastasis from PC. Patient concerns: A 60-year-old woman underwent pancreaticoduodenectomy after neoadjuvant chemoradiotherapy for pancreatic head cancer. At 28 months after surgery, multiple lung metastases from PC were diagnosed, and chemotherapy was administered. After 59 months, chemotherapy was terminated because all target lesions had disappeared on imaging. Diagnosis: At 77 months after the initial surgery, bone metastasis in the left 9th rib was detected by positron emission tomography/computed tomography, which was performed due to elevated carbohydrate antigen 19-9 levels. Interventions: Chemotherapy was readministered as the initial treatment. Subsequently, due to the long-term well-controlled status of the recurrence site and the absence of other metastases, thoracoscopic-assisted partial resection of the left 9th rib was performed 128 months following pancreaticoduodenectomy. Pathological examination revealed adenocarcinoma metastasis from PC. Outcomes: The patient is currently alive without recurrence 44 months after resection for bone metastasis and 172 months after the initial surgery. Conclusion: Surgical resection may be favorable in patients with bone metastasis of PC that is well-controlled with chemotherapy.

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“…The early symptoms of PC are insidious and di cult to detect, and many patients have already developed metastases by the time of diagnosis. The incidences of liver, lung, bone, and brain metastasis from PC are 45.1%, 11.4%, 3.8%, and 0.4%, respectively, suggesting that the liver is the most common organ of distant PC metastasis (5). Studies have shown that the organs of metastasis exhibit microscopic changes that favor metastatic growth, known as "pre-metastatic niches (PMNs) ".…”

Section: Introductionmentioning

confidence: 99%

Construction and Validation of Risk Factors and Prognostic Model for Liver Metastasis of Pancreatic Cancer

Zhang

Shi

Renjun

et al. 2023

Preprint

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Background Pancreatic cancer (PC) is a common malignancy that often metastasizes to the liver. The presence of liver metastasis (LM) in PC significantly impacts treatment selection and prognosis, but factors affecting the occurrence and prognosis of pancreatic cancer with liver metastasis (PCLM) are not well described. Methods Patients diagnosed with PC between 2010 and 2015 were selected from the Surveillance Epidemiology and End Results (SEER) database. Independent risk factors for PCLM were identified using univariable and multivariable logistic regression. Independent prognostic factors affecting the overall survival (OS) of PCLM patients were analyzed by univariate and multivariate Cox regression, and two nomograms were constructed to predict the risk and prognosis of PCLM. Nomograms were evaluated by receiver operating characteristic (ROC) analysis, C-index, calibration plots, and decision curve analysis (DCA). Results Multivariate logistic regression showed that age, primary site, grade, histological subtype, N stage, radiotherapy, surgery, bone metastasis, and lung metastasis were independent risk factors for PCLM. Multivariable COX regression showed that age, grade, histological subtype, surgery, radiotherapy, chemotherapy and lung metastasis were independent prognostic factors for PCLM. Diagnostic and prognostic nomograms were constructed based on the ROC curves, C-index, calibration curves and DCA curves, and both nomograms showed good predictive performance and clinical utility. Conclusion The two nomograms constructed in this study exhibit good predictive performance in the risk and prognosis of PCLM and may thus serve as a guide for future clinical management of PCLM.

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Clinicopathological Features, Prognostic Factors and Survival in Patients With Pancreatic Cancer Bone Metastasis

Cited by 10 publications

References 42 publications

Risk factors and predictive nomograms for early death of patients with pancreatic cancer liver metastasis: A large cohort study based on the SEER database and Chinese population

Risk factors and predictive nomograms for early death of patients with pancreatic cancer liver metastasis: A large cohort study based on the SEER database and Chinese population

Long-term survival after surgical resection for bone metastasis from pancreatic cancer: A case report

Construction and Validation of Risk Factors and Prognostic Model for Liver Metastasis of Pancreatic Cancer

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