title: [Multidisciplinary treatment and survival analysis for 497 cases of pancreatic cancer with liver metastases].
abstract: OBJECTIVE
  To explore the multidisciplinary therapeutic mode, clinical effect and prognostic factors of pancreatic cancer with liver metastases (PCLM).
  
  
  METHODS
  We retrospectively selected 497 consecutive patients with PCLM who were pathologically diagnosed and treated at Tianjin Medical University Cancer Hospital, from January, 2000 to December, 2012. Clinical characteristics, treatment modality, survival condition and factors associated with prognosis of these cases were analyzed, and efficacy of multidisciplinary treatment model was evaluated.
  
  
  RESULTS
  Of these patients, the male/female ratio was 1.85∶1, with a median age of 59. A total of 358 (72.0%) cases had synchronous liver metastases, and 173 (34.8%) cases complicated with extrahepatic metastases. The 0.5, 1, 3, 5 year survival rates of 497 patients were 44.1%, 19.7%, 3.2% and 2.2%, respectively, with a median survival (MS) of 5.4 months. Patients who were treated with 3 or more approaches (including surgery, chemotherapy, radiation therapy, interventional therapy, and physiotherapy) had a longer median survival time than patients treated with 2 or only 1 approach (MS: 8.6 vs 5.2 vs 4.6 months, P< 0.001). Multivariate analysis for clinical features and treatment modality showed that age, weight loss, ascites, karnofsky performance score (KPS), primary site resection, albumin, carbohydrate antigen (CA) 19-9, resection of liver metastases, radiation therapy and systemic chemotherapy were prognostic variables with statistical significance.
  
  
  CONCLUSIONS
  PCLM is a refractory malignant tumor. Age >60, weight loss (≥10% within 3 months), ascites, KPS <80, albumin<35 g/L, and CA19-9 ≥500 U/ml were the most relevant predictors of poor survival. Multimodal treatment using curative resection of pancreatic cancer and/or liver metastases, systemic chemotherapy and radiation therapy may improve the prognosis and survival rate sufficiently.
authors.affiliation: Tianjin Medical University Cancer Hospital, National Clinical Research Center of Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, China.
authors.forename: H H
authors.initials: HH
authors.lastname: Ouyang
authors.forename: Z Y
authors.initials: ZY
authors.lastname: Pan
authors.forename: W D
authors.initials: WD
authors.lastname: Ma
authors.forename: L J
authors.initials: LJ
authors.lastname: Zhao
authors.forename: T
authors.initials: T
authors.lastname: Zhang
authors.forename: F
authors.initials: F
authors.lastname: Liu
authors.forename: M M
authors.initials: MM
authors.lastname: Quan
mesh_terms: D018395:CA-19-9 Antigen / Q000097:blood; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality* / Q000556:secondary; D008297:Male; D015999:Multivariate Analysis; D010190:Pancreatic Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D018395:CA-19-9 Antigen