Heterogeneity of metastatic pancreatic adenocarcinoma: Lung metastasis show better prognosis than liver metastasis—a case control study
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Claire Decoster1, Marine Gilabert1, Aurélie Autret1,2, Olivier Turrini3, Sandrine Oziel-Taieb1, Flora Poizat4, Marc Giovannini1, Patrice Viens1, Juan Iovanna5, Jean-Luc Raoul1
1Department of Medical Oncology, Paoli-Calmettes Institute, Marseille 13273, France
2Biostatistic Unit, Paoli-Calmettes Institute, Marseille 13273, France
3Department of Digestive Surgery, Paoli-Calmettes Institute, Marseille 13273, France
4Department of Pathology, Paoli-Calmettes Institute, Marseille 13273, France
5Centre de Recherche en Cancérologie de Marseille (CRCM), INSERM U1068, CNRS UMR 7258, Aix-Marseille University and Paoli-Calmettes Institute, Marseille 13273, France
Raoul Jean-Luc, email: email@example.com
Keywords: pancreatic adenocarcinoma, lung metastases, prognosis, overall survival, local evolution
Received: November 11, 2015 Accepted: May 08, 2016 Published: June 06, 2016
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.
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