Portal de Periódicos da CAPES

Heterogeneity of metastatic pancreatic adenocarcinoma: Lung metastasis show better prognosis than liver metastasis—a case control study

2016; Impact Journals LLC; Volume: 7; Issue: 29 Linguagem: Inglês

10.18632/oncotarget.9861

1949-2553

Claire Decoster, Marine Gilabert, A Autret, Olivıer Turrini, Sandrine Oziel-Taïeb, Flora Poizat, Marc Giovannini, Patrice Viens, Juan Iovanna, Jean‐Luc Raoul,

Cancer Genomics and Diagnostics

// Claire Decoster 1 , Marine Gilabert 1 , Aurélie Autret 1, 2 , Olivier Turrini 3 , Sandrine Oziel-Taieb 1 , Flora Poizat 4 , Marc Giovannini 1 , Patrice Viens 1 , Juan Iovanna 5 , Jean-Luc Raoul 1 1 Department of Medical Oncology, Paoli-Calmettes Institute, Marseille 13273, France 2 Biostatistic Unit, Paoli-Calmettes Institute, Marseille 13273, France 3 Department of Digestive Surgery, Paoli-Calmettes Institute, Marseille 13273, France 4 Department of Pathology, Paoli-Calmettes Institute, Marseille 13273, France 5 Centre de Recherche en Cancérologie de Marseille (CRCM), INSERM U1068, CNRS UMR 7258, Aix-Marseille University and Paoli-Calmettes Institute, Marseille 13273, France Correspondence to: Raoul Jean-Luc, email: raouljl@ipc.unicancer.fr Keywords: pancreatic adenocarcinoma, lung metastases, prognosis, overall survival, local evolution Received: November 11, 2015 Accepted: May 08, 2016 Published: June 06, 2016 ABSTRACT 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.