Lung Metastases in Patients with Stage IV Pancreatic Cancer: Prevalence, Risk Factors, and Survival Impact

Abstract

The aim of this study was to evaluate the prevalence, the clinicopathological variables associated with probability of lung metastases, and the impact of lung metastases on survival outcome in patients with stage IV pancreatic cancer (PC) treated with palliative chemotherapy. A total of 654 patients with stage IV PC who underwent palliative chemotherapy from 2010–2016 were retrospectively enrolled in this study. Possible clinical variables associated with lung metastases and survival outcome were examined by univariate and multivariate analysis. Lung metastases were detected in 15.0% (3.4% with isolated lung metastases and 11.6% with synchronic metastases to lung and other organs). Female gender, poorly differentiated tumor grade, and large primary tumor size were independent risk factor in multivariate analysis. The median overall survival (OS) time was 6.5 months in the entire cohort, while the median OS was 11.8, 6.9, 7.7, 10.1, and 5.0 months for patients with isolated lung, isolated liver, isolated peritoneum, isolated distant lymph nodes, and multiple sites metastases, respectively. Isolated lung metastases were a better prognosticator for OS in univariate and multivariate analysis. This study utilized real-world clinical practice data to assess the prevalence, risk factors, and survival impact of lung metastases in patients with stage IV pancreatic cancer.

Two Novel Nomograms Predicting the Risk and Prognosis of Pancreatic Cancer Patients With Lung Metastases: A Population-Based Study

“…Besides, the incidence of PCLM in our study was 4.2%, which could be attributed to our strict inclusion criteria and the inclusion of more pathological types of PC cases. Astonishingly, this is very similar to previous research on lung metastasis in other cancers based on SEER database ( 26 – 28 ). To the best of our knowledge, this is the first population-based study that describes the diagnostic and prognostic factors of PCLM patients.…”

Locoregional Treatment of Metastatic Pancreatic Cancer Utilizing Resection, Ablation and Embolization: A Systematic Review

“…The majority of studies on liver-directed therapy (LDT) in mPDAC concern the surgical removal of liver metastases in addition to primary resection ( Table 3 ) [ 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 ]. A total of 18 articles were identified on this topic including 938 patients with mPDAC spread to the liver, of whom 528 received primary pancreatic resection in combination with hepatic metastasectomy.…”

“…This major discrepancy may be a consequence of low patient numbers in combination with variable inclusion criteria (i.e., resection margin). Bahra et al [ 54 ] specifically stratified survival outcomes on the basis of the primary resection status. The mOS of mPDAC with R0, R1 and R2 margins were 14.4, 7.3 and 6.1 months, respectively, demonstrating the substantial influence of the pancreatic resection margin status on survival.…”

“…In PDAC, the most significant predictor of long-term survival is an R0 resection of the primary tumor since this remains the only possible curative option. Primary resection (margin) status was a frequently mentioned significant prognostic factor [ 20 , 21 , 22 , 23 , 24 , 28 , 31 , 37 , 46 , 54 ], confirming its substantial influence on survival and highlights its advantage as patient selection criterium [ 26 , 52 , 86 ]. However, this is specifically the case for metachronous disease, as for synchronous disease intra-operative efforts must be made to attain this information.…”

Unexpected Favorable Outcome To Sintinib Monotherapy in A Relapse PDAC Patient With High TMB

“…PDAC is one of the most aggressive and lethal cancers with a median overall survival of only 6.9 months for isolated liver metastases patients [15]. Increased median overall survival has been obtained of 8.5 months when treated with nabpaclitaxelgemcitabine [16].…”