Liver metastasis as an initial recurrence has no impact on the survival of patients with resectable pancreatic adenocarcinoma

Tani, Masaji; Kawai, Manabu; Miyazawa, Motoki; Hirono, Seiko; Ina, Shinomi; Nishioka, Ryohei; Fujita, Yoichi; Uchiyama, Kazuhisa; Yamaue, Hiroki

doi:10.1007/s00423-008-0296-4

Cited by 27 publications

(19 citation statements)

References 33 publications

(49 reference statements)

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“…9 Moreover, associations observed in earlier studies vary considerably, possibly due to limited sample size and length of follow-up. For instance, van den Broeck et al 6 found no association between recurrence location and survival, while Tani et al 17 found similar median OS for patients with and without initial liver metastases. However, other studies did find significant correlations between patterns of recurrence and survival outcomes.…”

Section: Discussionmentioning

confidence: 99%

Implications of the Pattern of Disease Recurrence on Survival Following Pancreatectomy for Pancreatic Ductal Adenocarcinoma

et al. 2018

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Background. After radical resection of pancreatic ductal adenocarcinoma (PDAC), approximately 80% of patients will develop disease recurrence. It remains unclear to what extent the location of recurrence carries prognostic significance. Additionally, stratifying the pattern of recurrence may lead to a deeper understanding of the heterogeneous biological behavior of PDAC. Objective. The aim of this study was to characterize the relationship of recurrence patterns with survival in patients with resected PDAC. Methods. This single-center cohort study included patients undergoing pancreatectomy at the Johns Hopkins Hospital between 2000 and 2013. Exclusion criteria were neoadjuvant therapy and incomplete follow-up. Sites of first recurrence were stratified into five groups and survival outcomes were estimated using Kaplan–Meier curves. The association of specific recurrence locations with overall survival (OS) was analyzed using Cox proportional-hazards models with and without landmark analysis. Results. Accurate follow-up data were available for 877 patients, 662 (75.5%) of whom had documented recurrence at last follow-up. Patients with multiple-site (n = 227, 4.7 months) or liver-only recurrence (n = 166, 7.2 months) had significantly worse median survival after recurrence when compared with lung- (n = 93) or local-only (n = 158) recurrence (15.4 and 9.7 months, respectively). On multivariable analysis, the unique recurrence patterns had variable predictive values for OS. Landmark analyses, with landmarks set at 12, 18, and 24 months, confirmed these findings. Conclusions. This study demonstrates that specific patterns of PDAC recurrence result in different survival outcomes. Furthermore, distinct first recurrence locations have unique independent predictive values for OS, which could help with prognostic stratification and decisions regarding treatment after the diagnosis of recurrence.

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Section: Discussionmentioning

confidence: 99%

Implications of the Pattern of Disease Recurrence on Survival Following Pancreatectomy for Pancreatic Ductal Adenocarcinoma

et al. 2018

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“…Zhang et al [17] reported that the presence of ascites, along with low serum levels of choline esterase and an age >65 years, resulted in an extremely poor prognosis in advanced pancreatic cancer even after palliative chemotherapy. Tani et al [18] demonstrated that if the first recurrence of the disease was liver metastasis, it had no impact on the median survival duration in patients who had undergone curative surgery. However, their study was confined to recurring disease.…”

Section: Discussionmentioning

confidence: 99%

A Prognostic Model to Predict Clinical Outcomes with First-Line Gemcitabine-Based Chemotherapy in Advanced Pancreatic Cancer

Lee

Park

et al. 2011

Oncology

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Objective: Our aim was to devise a prognostic model for advanced pancreatic cancer based on clinical parameters. Methods: We retrospectively analyzed the medical records of 298 patients who received gemcitabine-based chemotherapy from January 1999 to November 2008. Results: The median survival of all patients was 7 months [95% confidence interval (CI) 6.2–7.8]. Multivariate analysis revealed poor prognostic factors for overall survival such as the presence of liver metastasis [p < 0.001, hazard ratio (HR) 2.628, 95% CI 1.620–4.264], the presence of ascites or peritoneal carcinomatosis (p = 0.005, HR 1.783, 95% CI 1.194–2.661), serum C-reactive protein levels >1.2 mg/dl (p = 0.021, HR 1.568, 95% CI 1.070–2.300), and serum albumin levels <3.5 g/dl (p = 0.021, HR 1.701, 95% CI 1.085–2.667). Of 298 patients, 168 patients (56.4%) were categorized as low-risk with 0 or 1 risk factor, 80 patients (26.8%) were categorized as intermediate-risk with 2 risk factors, and 50 patients (16.8%) were categorized as high-risk with 3 or 4 risk factors. The median survival duration for the low-, intermediate-, and high-risk groups was 10.0 months (95% CI 8.7–11.3), 6.7 months (95% CI 5.7–7.7), and 4.4 months (95% CI 3.2–5.6), respectively. Conclusions: This prognostic model could help to select treatment for patients in clinical practice, and these risk-adapted treatment strategies should be further investigated in prospective studies in such patient populations.

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“…PA usually metastasizes to regional nodes, liver, adjacent organs and lungs [114,123] and the incidence of brain metastases is extremely low. Thus, even when patients have metastatic tumors in the brain, the majority of them may die from primary lesions before exhibiting neurologic signs, which may result in the low reported incidence of the metastatic brain tumors from pancreatic cancer [124].…”

Section: Metastases Treatmentmentioning

confidence: 99%

Metastases of pancreatic adenocarcinoma: A systematic review of literature and a new functional concept

Cannistrà

Ruggiero

Zullo

et al. 2015

International Journal of Surgery

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Liver metastasis as an initial recurrence has no impact on the survival of patients with resectable pancreatic adenocarcinoma

Abstract: We concluded potentially supporting the hypothesis that even patients thought to be at higher risk of liver metastasis may still be given the chance of resection, considering the satisfying survival.

Cited by 27 publications

References 33 publications

Implications of the Pattern of Disease Recurrence on Survival Following Pancreatectomy for Pancreatic Ductal Adenocarcinoma

Implications of the Pattern of Disease Recurrence on Survival Following Pancreatectomy for Pancreatic Ductal Adenocarcinoma

A Prognostic Model to Predict Clinical Outcomes with First-Line Gemcitabine-Based Chemotherapy in Advanced Pancreatic Cancer

Metastases of pancreatic adenocarcinoma: A systematic review of literature and a new functional concept

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