Metastatic PDAC: tail origin tumors linked to worse outcomes

  • Mackay TM & al.
  • Eur J Cancer
  • 23 Nov 2018

  • curated by Jim Kling
  • Univadis Clinical Summaries
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Takeaway

  • In patients with metastasized pancreatic ductal adenocarcinoma (PDAC), tail origin of the tumor was associated with a unique metastatic profile and shortened survival.

Why this matters

  • Previous studies have not examined the relationship among primary tumor location, metastatic patterns, and survival.
  • Some small, nonrandomized studies have indicated that local ablative therapy or surgery may be sufficient for patients with favorable outcomes.

Study design

  • Retrospective analysis of adults diagnosed with PDAC or suspected PDAC in the Netherlands between 2005 and 2015 (n=9952).
  • Funding: Dutch Cancer Society.

Key results

  • Location of primary tumor: 57% head, 17% body, 26% tail.
  • Percentage of tumors >4 cm in size by primary tumor location: head, 26%; body, 41%; tail, 52% (P<.0001>
  • Percentage with ≥3 metastases: tail, 15%; body, 9%; head, 5% (P<.0001>
  • Percentage of cases with peritoneal metastases: tail, 30%; body, 24%; head, 13% (P<.0001 tail origin tumors also had higher proportions of liver lung and other metastases although these differences were less pronounced.>
  • Median OS: tail, 1.9 months (HR compared with head, 1.20; 95% CI, 1.15-1.26); body, 2.4 months; head, 2.6 months.

Limitations

  • Retrospective analysis.

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