Tao LY, et al. - Researchers aim was to assess the survival of patients diagnosed with metastatic pancreatic cancer (mPC) in accordance with local treatment of the primary tumor. As per findings, in these patients, local treatment had the primary benefit of both cancer-specific survival and overall survival. Results might guide the management of this patient population.

Methods

• From the Surveillance, Epidemiology and End Results (SEER) database, researchers identified patients diagnosed with stage IV mPC between 2004 and 2013.
• They determined cancer-specific survival (CSS) and overall survival (OS) using the Kaplan–Meier method with the log-rank test.
• They conducted multivariable survival analyses of CSS and OS using the Cox proportional hazard model.

Results

• This analysis included 28918 patients with mPC.
• 467 patients underwent surgical resection (1.6%) and 28451 patients did not (98.4%).
• Patients who were younger than 70 years (odds ratio [OR]=1.45, 95% CI=1.04–2.03, p=0.03), diagnosed from 2004 to 2008 (OR=1.49, 95% CI=1.25–1.80, p<0.001), female (OR=1.31, 95% CI=1.08–1.58, p<0.001), married (OR=1.56, 95% CI=1.27–1.90, p<0.001), at T3 stage (OR=3.53, 95% CI=1.10–11.37, p=0.035), at N1 stage (OR=2.05, 95% CI=1.68–2.50, p<0.001), presenting histological types other than adenocarcinoma (OR=2.04, 95% CI=1.43–2.94, p<0.001), and with tumor of the pancreatic head (OR=1.90, 95% CI=1.27–2.82,p=0.002) more frequently received surgical resection.
• Multivariate analysis revealed CSS benefits with surgical resection of the primary tumor(hazard ratio [HR]=0.58, 95% CI=0.52–0.64, p<0.001) and OS (HR=0.59, 95% CI=0.53–0.65, p<0.001).
• Furthermore, factors associated with poor survival included not receiving chemotherapy (HR=2.33, 95% CI=2.27–2.39, p<0.001), age >50 years (HR=1.25, 95% CI=1.09–1.42, p=0.001), male (HR=1.121, 95% CI=1.09–1.15, p<0.001), black ethnicity (HR=1.11, 95% CI=1.1–1.15, p<0.001), unmarried (HR=1.20, 95% CI=1.17–1.23, p<0.001), histological type of adenocarcinoma (HR=1.18, 95% CI=1.14–1.22, p<0.001), and primary site other than the pancreatic head (HR=1.08, 95% CI=1.05–1.11, p<0.001).