Heterogeneity of metastatic pancreatic adenocarcinoma: Lung metastasis show better prognosis than liver metastasis-a case control study.
The prognosis of metastatic pancreatic ductal adenocarcinoma (PDAC) is grim, with a median overall survival of under 1 year. In our clinical practice, we observed a few cases of isolated lung metastases from PDAC with unusually long outcomes. We compared these cases in a case-control study of lung-only vs. liver-only metastases from PDAC.From our database, we found 37 cases of lung-only metastases and paired them with 37 cases of liver-only metastases by age, tumor location and treatment.The lung-only group differed significantly from the liver-only group with respect to the following parameters: female predominance, more metachronous cases, fewer nodules per patient, and smaller increases in tumor markers. Local invasion parameters (i.e., arterial or venous involvement) were not significantly different. The outcomes were significantly different, with a median overall survival from the occurrence of metastases of 20.8 vs. 9.1 months and a median progression-free survival of 11 vs. 3.5 months.In conclusion, this case-control study seemed to confirm that lung-only PDAC metastases have prognoses different from those of liver-only metastases. A better understanding of the mechanisms underlying these differences will help identify abnormalities associated with tumor aggressiveness.
Department of Medical Oncology, Paoli-Calmettes Institute, Marseille 13273, France.
Claire
C
Decoster
Department of Medical Oncology, Paoli-Calmettes Institute, Marseille 13273, France.
Marine
M
Gilabert
Department of Medical Oncology, Paoli-Calmettes Institute, Marseille 13273, France.|Biostatistic Unit, Paoli-Calmettes Institute, Marseille 13273, France.
Aurélie
A
Autret
Department of Digestive Surgery, Paoli-Calmettes Institute, Marseille 13273, France.
Olivier
O
Turrini
Department of Medical Oncology, Paoli-Calmettes Institute, Marseille 13273, France.
Sandrine
S
Oziel-Taieb
Department of Pathology, Paoli-Calmettes Institute, Marseille 13273, France.
Flora
F
Poizat
Department of Medical Oncology, Paoli-Calmettes Institute, Marseille 13273, France.
Marc
M
Giovannini
Department of Medical Oncology, Paoli-Calmettes Institute, Marseille 13273, France.
Patrice
P
Viens
Centre de Recherche en Cancérologie de Marseille (CRCM), INSERM U1068, CNRS UMR 7258, Aix-Marseille University and Paoli-Calmettes Institute, Marseille 13273, France.
Juan
J
Iovanna
Department of Medical Oncology, Paoli-Calmettes Institute, Marseille 13273, France.
Jean-Luc
JL
Raoul
D000368:Aged; D000369:Aged, 80 and over; D021441:Carcinoma, Pancreatic Ductal / Q000401:mortality / Q000556:secondary*; D016022:Case-Control Studies; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000401:mortality / Q000556:secondary*; D008175:Lung Neoplasms / Q000401:mortality / Q000556:secondary*; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000473:pathology*; D011379:Prognosis
local evolution; lung metastases; overall survival; pancreatic adenocarcinoma; prognosis