E. Alouani , C. Canivet , B. Bournet , L. Buscail , J. Selves , B. Napoleon , L. Palazzo , N. Flori , P. Guibert , A.-C. Brunac , C. Maulat , F. Muscari , F.-Z. Mokrane , S. Gourgou , L. Roca , R. Guimbaud , N. Fares
{"title":"同步转移性胰腺腺癌（PDAC）的转移部位是否影响生存？一项前瞻性现实世界BACAP研究","authors":"E. Alouani , C. Canivet , B. Bournet , L. Buscail , J. Selves , B. Napoleon , L. Palazzo , N. Flori , P. Guibert , A.-C. Brunac , C. Maulat , F. Muscari , F.-Z. Mokrane , S. Gourgou , L. Roca , R. Guimbaud , N. Fares","doi":"10.1016/j.esmogo.2025.100144","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Advanced pancreatic ductal adenocarcinoma (PDAC) carries a dismal prognosis with a 5-year survival rate of 3%. While treated as an even population, previous retrospective studies suggested significantly different survival rates for patients with lung-only metastases when compared with other patients. This study aims to explore prospectively the difference in survival outcome based on initial site of metastases in synchronous metastatic PDAC.</div></div><div><h3>Patients and methods</h3><div>This is a prospective observational study including all adult patients with synchronous metastatic PDAC in BACAP (national Anatomo-Clinical Database on Pancreatic Adenocarcinoma). Data regarding patients’ demographics, tumor characteristics and survival outcomes were analyzed.</div></div><div><h3>Results</h3><div>Overall, 559 patients were included (52.8% male, mean age 69 years) of which 26 (4.7%), 65 (11.6%), 299 (53.5%) and 169 (30.2%) patients had lung-only, peritoneal-only, liver-only and multi-site metastases at diagnosis, respectively. The median overall survival (OS) was significantly different according to metastatic site (<em>P</em> < 0.001) with a median OS for lung-only, peritoneum-only, liver-only and multi-site of 12.6 months [95% confidence interval (CI) 9.7-16.9 months], 8.6 months (95% CI 5.4-11.5 months), 7.9 months (95% CI 6.5-8.9 months) and 4.5 months (95% CI 3.9-5.8 months), respectively. The median progression-free survival (PFS) was also significantly different according to metastatic site (<em>P</em> < 0.01) with a median PFS of 6.3 months (95% CI 2.7-9.1 months), 5.1 months (95% CI 3.7-6.2 months), 4.7 months (95% CI 3.3-5.7 months) and 3.2 months (95% CI 2.6-4.1 months), respectively.</div></div><div><h3>Conclusions</h3><div>Patients with lung-only metastases represented 4.7% of synchronous metastatic PDAC patients and exhibited improved survival. These results suggest that a subset of patients with synchronous metastatic PDAC could benefit from more aggressive locoregional treatments.</div></div>","PeriodicalId":100490,"journal":{"name":"ESMO Gastrointestinal Oncology","volume":"8 ","pages":"Article 100144"},"PeriodicalIF":0.0000,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Is survival influenced by metastatic site in synchronous metastatic pancreatic adenocarcinoma (PDAC)? A prospective real-world BACAP study\",\"authors\":\"E. Alouani , C. Canivet , B. Bournet , L. Buscail , J. Selves , B. Napoleon , L. Palazzo , N. Flori , P. Guibert , A.-C. Brunac , C. Maulat , F. Muscari , F.-Z. Mokrane , S. Gourgou , L. Roca , R. Guimbaud , N. Fares\",\"doi\":\"10.1016/j.esmogo.2025.100144\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>Advanced pancreatic ductal adenocarcinoma (PDAC) carries a dismal prognosis with a 5-year survival rate of 3%. While treated as an even population, previous retrospective studies suggested significantly different survival rates for patients with lung-only metastases when compared with other patients. This study aims to explore prospectively the difference in survival outcome based on initial site of metastases in synchronous metastatic PDAC.</div></div><div><h3>Patients and methods</h3><div>This is a prospective observational study including all adult patients with synchronous metastatic PDAC in BACAP (national Anatomo-Clinical Database on Pancreatic Adenocarcinoma). Data regarding patients’ demographics, tumor characteristics and survival outcomes were analyzed.</div></div><div><h3>Results</h3><div>Overall, 559 patients were included (52.8% male, mean age 69 years) of which 26 (4.7%), 65 (11.6%), 299 (53.5%) and 169 (30.2%) patients had lung-only, peritoneal-only, liver-only and multi-site metastases at diagnosis, respectively. The median overall survival (OS) was significantly different according to metastatic site (<em>P</em> < 0.001) with a median OS for lung-only, peritoneum-only, liver-only and multi-site of 12.6 months [95% confidence interval (CI) 9.7-16.9 months], 8.6 months (95% CI 5.4-11.5 months), 7.9 months (95% CI 6.5-8.9 months) and 4.5 months (95% CI 3.9-5.8 months), respectively. The median progression-free survival (PFS) was also significantly different according to metastatic site (<em>P</em> < 0.01) with a median PFS of 6.3 months (95% CI 2.7-9.1 months), 5.1 months (95% CI 3.7-6.2 months), 4.7 months (95% CI 3.3-5.7 months) and 3.2 months (95% CI 2.6-4.1 months), respectively.</div></div><div><h3>Conclusions</h3><div>Patients with lung-only metastases represented 4.7% of synchronous metastatic PDAC patients and exhibited improved survival. These results suggest that a subset of patients with synchronous metastatic PDAC could benefit from more aggressive locoregional treatments.</div></div>\",\"PeriodicalId\":100490,\"journal\":{\"name\":\"ESMO Gastrointestinal Oncology\",\"volume\":\"8 \",\"pages\":\"Article 100144\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-02-26\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"ESMO Gastrointestinal Oncology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2949819825000135\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"ESMO Gastrointestinal Oncology","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2949819825000135","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
晚期胰腺导管腺癌（PDAC）预后不佳，5年生存率为3%。虽然作为一个均匀的人群来对待，但之前的回顾性研究表明，与其他患者相比，仅肺转移患者的生存率有显著差异。本研究旨在前瞻性地探讨同步转移性PDAC中基于初始转移部位的生存结果差异。患者和方法这是一项前瞻性观察性研究，包括BACAP（国家胰腺腺癌解剖-临床数据库）中所有同步转移性PDAC的成年患者。分析患者人口统计学、肿瘤特征和生存结局等数据。结果共纳入559例患者（男性52.8%，平均年龄69岁），其中诊断时肺转移26例（4.7%），腹膜转移65例（11.6%），肝转移299例（53.5%），多部位转移169例（30.2%）。中位总生存期（OS）因转移部位不同而有显著差异(P <；0.001)，仅肺、仅腹膜、仅肝和多部位的中位OS分别为12.6个月[95%可信区间（CI） 9.7-16.9个月]、8.6个月（95% CI 5.4-11.5个月）、7.9个月（95% CI 6.5-8.9个月）和4.5个月（95% CI 3.9-5.8个月）。根据转移部位的不同，中位无进展生存期（PFS）也有显著差异(P <；0.01)，中位PFS分别为6.3个月（95% CI 2.7-9.1个月）、5.1个月（95% CI 3.7-6.2个月）、4.7个月（95% CI 3.3-5.7个月）和3.2个月（95% CI 2.6-4.1个月）。结论仅肺转移患者占同步转移性PDAC患者的4.7%，且生存率提高。这些结果表明，一部分同步转移性PDAC患者可以从更积极的局部治疗中获益。
Is survival influenced by metastatic site in synchronous metastatic pancreatic adenocarcinoma (PDAC)? A prospective real-world BACAP study
Background
Advanced pancreatic ductal adenocarcinoma (PDAC) carries a dismal prognosis with a 5-year survival rate of 3%. While treated as an even population, previous retrospective studies suggested significantly different survival rates for patients with lung-only metastases when compared with other patients. This study aims to explore prospectively the difference in survival outcome based on initial site of metastases in synchronous metastatic PDAC.
Patients and methods
This is a prospective observational study including all adult patients with synchronous metastatic PDAC in BACAP (national Anatomo-Clinical Database on Pancreatic Adenocarcinoma). Data regarding patients’ demographics, tumor characteristics and survival outcomes were analyzed.
Results
Overall, 559 patients were included (52.8% male, mean age 69 years) of which 26 (4.7%), 65 (11.6%), 299 (53.5%) and 169 (30.2%) patients had lung-only, peritoneal-only, liver-only and multi-site metastases at diagnosis, respectively. The median overall survival (OS) was significantly different according to metastatic site (P < 0.001) with a median OS for lung-only, peritoneum-only, liver-only and multi-site of 12.6 months [95% confidence interval (CI) 9.7-16.9 months], 8.6 months (95% CI 5.4-11.5 months), 7.9 months (95% CI 6.5-8.9 months) and 4.5 months (95% CI 3.9-5.8 months), respectively. The median progression-free survival (PFS) was also significantly different according to metastatic site (P < 0.01) with a median PFS of 6.3 months (95% CI 2.7-9.1 months), 5.1 months (95% CI 3.7-6.2 months), 4.7 months (95% CI 3.3-5.7 months) and 3.2 months (95% CI 2.6-4.1 months), respectively.
Conclusions
Patients with lung-only metastases represented 4.7% of synchronous metastatic PDAC patients and exhibited improved survival. These results suggest that a subset of patients with synchronous metastatic PDAC could benefit from more aggressive locoregional treatments.
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