ESMO Gastrointestinal Oncology (Jun 2025)

Is survival influenced by metastatic site in synchronous metastatic pancreatic adenocarcinoma (PDAC)? A prospective real-world BACAP study

  • 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,
  • Barbara Bournet,
  • Cindy Canivet,
  • Louis Buscail,
  • Nicolas Carrere,
  • Fabrice Muscari,
  • Bertrand Suc,
  • Rosine Guimbaud,
  • Corinne Couteau,
  • Marion Deslandres,
  • Pascale Rivera,
  • Anne-Pascale Laurenty,
  • Nadim Fares,
  • Karl Barange,
  • Janick Selves,
  • Anne Gomez-Brouchet,
  • Bertrand Napoleon,
  • Bertrand Pujol,
  • Fabien Fumex,
  • Jerome Desrame,
  • Christine Lefort,
  • Vincent Lepilliez,
  • Rodica Gincul,
  • Pascal Artru,
  • Lea Clavel,
  • Anne-Isabelle Lemaistre,
  • Laurent Palazzo,
  • Jerome Cros,
  • Sarah Tubiana,
  • Nicolas Flori,
  • Pierre Senesse,
  • Pierre-Emmanuel Colombo,
  • Emmanuelle SamailScalzi,
  • Fabienne Portales,
  • Sophie Gourgou,
  • Claire Honfo Ga,
  • Carine Plassot,
  • Julien Fraisse,
  • Fred eric Bibeau,
  • Marc Ychou,
  • Pierre Guibert,
  • Christelle de la Fouchardiere,
  • Matthieu Sarabi,
  • Patrice Peyrat,
  • Severine Tabone-Eglinger,
  • Caroline Renard,
  • Guillaume Piessen,
  • Stephanie Truant,
  • Alain Saudemont,
  • Guillaume Millet,
  • Florence Renaud,
  • Emmanuelle Leteurtre,
  • Patrick Gele,
  • Eric Assenat,
  • Jean-Michel Fabre,
  • Francois-Regis Souche,
  • Marie Dupuy,
  • Anne-Marie Gorce-Dupuy,
  • Jeanne Ramos,
  • Jean-Francois Seitz,
  • Jean Hardwigsen,
  • Emmanuelle Norguet-Monnereau,
  • Philippe Grandval,
  • Muriel Duluc,
  • Dominique Figarella-Branger,
  • Veronique Vendrely,
  • Clement Subtil,
  • Eric Terrebonne,
  • Jean-Frederic Blanc,
  • Etienne Buscail,
  • Jean-Philippe Merlio,
  • Dominique Farges Bancel,
  • Jean-Marc Gornet,
  • Daniela Geromin,
  • Geoffroy Vanbiervliet,
  • Anne-Claire Frin,
  • Delphine Ouvrier,
  • Marie-Christine SaintPaul,
  • Philippe Berthelemy,
  • Chelbabi Fouad,
  • Stephane Garcia,
  • Nathalie Lesavre,
  • Mohamed Gasmi,
  • Marc Barthet,
  • Vanessa Cottet,
  • Cyrille Delpierre

Journal volume & issue
Vol. 8
p. 100144

Abstract

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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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