ArticlePancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.]2024
The impact of metastatic sites on survival Rates and predictors of extended survival in patients with metastatic pancreatic cancer.
Article in Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.], 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed.
- Pulmonary Metastasis of Pancreatic Ductal Adenocarcinoma-A Distinct Entity Conferring Better Prognosis and Requiring Therapeutic Paradigm Shift.Annals of surgical oncology · 2026Article
- Initial Site of Metastasis Influences Prognosis in Pancreatic Ductal Adenocarcinoma.Cancer medicine · 2026Article
- Fibroblast STAT3 Activation Drives Organ-Specific Premetastatic Niche Formation.Cancer research · 2026Article
- Clinical subtypes of stage IV pancreatic ductal adenocarcinoma: a new perspective of clinical practices.Cancer metastasis reviews · 2025Review
- High FGFR4 protein expression, but not FGFR1 or FGFR2, predicts poor prognosis in pancreatic ductal adenocarcinoma.BMC cancer · 2025Article
- A Qualitative Study Examining Caregivers' Perspectives on Healthcare System Barriers and Facilitators to Foregut Cancer Care.The Journal of surgical research · 2025Article
- New Marine-Inspired Oxadiazole Derivatives for Use Against Pancreatic Ductal Adenocarcinoma.Marine drugs · 2025Article
- Characterization and treatment of brain metastases from pancreatic cancer: a systematic review.Discover oncology · 2025Review
- Non-canonical ALK7 pathways promote pancreatic cancer metastasis through β-catenin/MMP-mediated basement membrane breakdown and intravasation.Molecular cancer · 2025Article
- Predictive and prognostic factors of efficacy of third-line chemotherapy in patients with unresectable pancreatic cancer: a cohort-based study.The oncologist · 2025Article
- Article
- Peritoneum carcinomatosis as a favourable prognostic factor for treatment with nanoliposomal irinotecan and fluorouracil plus leucovorin in advanced pancreatic cancer.Therapeutic advances in medical oncology · 2025Article
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Authors and funding
14 authors.
Funding
Abstract
BACKGROUND
objectivesThe aim of this study was to determine the role of site-specific metastatic patterns over time and assess factors associated with extended survival in metastatic PDAC. Half of all patients with pancreatic ductal adenocarcinoma (PDAC) present with metastatic disease. The site of metastasis plays a crucial role in clinical decision making due to its prognostic value.
methodsWe examined 56,757 stage-IV PDAC patients from the National Cancer Database (2016-2019), categorizing them by metastatic site: multiple, liver, lung, brain, bone, carcinomatosis, or other. The site-specific prognostic value was assessed using log-rank tests while time-varying effects were assessed by Aalen's linear hazards model. Factors associated with extended survival (>3years) were assessed with logistic regression.
resultsMedian overall survival (mOS) in patients with distant lymph node-only metastases (9.0 months) and lung-only metastases (8.1 months) was significantly longer than in patients with liver-only metastases (4.6 months, p < 0.001). However, after six months, the metastatic site lost prognostic value. Logistic regression identified extended survivors (3.6 %) as more likely to be younger, Hispanic, privately insured, Charlson-index <2, having received chemotherapy, or having undergone primary or distant site surgery (all p < 0.001).
conclusionWhile synchronous liver metastases are associated with worse outcomes than lung-only and lymph node-only metastases, this predictive value is diminished after six months. Therefore, treatment decisions beyond this time should not primarily depend on the metastatic site. Extended survival is possible in a small subset of patients with favorable tumor biology and good conditional status, who are more likely to undergo aggressive therapies.
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