• genetic profile
• metastasis
• pancreatic cancer
• prognostic factors
• treatment outcome

• Humans
• Male
• Female
• Lung Neoplasms/pathology
• Lung Neoplasms/genetics
• Lung Neoplasms/drug therapy
• Lung Neoplasms/mortality
• Liver Neoplasms/secondary
• Liver Neoplasms/genetics
• Liver Neoplasms/drug therapy
• Pancreatic Neoplasms/pathology
• Pancreatic Neoplasms/genetics
• Pancreatic Neoplasms/drug therapy
• Pancreatic Neoplasms/mortality
• Middle Aged
• Aged
• Retrospective Studies
• Mutation
• Adult
• Databases, Factual

• Career Development Award
• K08 CA259456 NCI NIH HHS
• K08 CA259456 NIH HHS
• American Society of Clinical Oncology
• Conquer Cancer Foundation

• Humans
• Pancreatic Neoplasms/genetics
• Pancreatic Neoplasms/pathology
• Prognosis
• Biomarkers, Tumor/genetics
• Carcinoma, Pancreatic Ductal/genetics
• Carcinoma, Pancreatic Ductal/pathology
• Genomics/methods
• Evolution, Molecular

• CA220508 National Cancer Institute (NCI)
• F31 CA260796 NCI NIH HHS
• R00 CA229979 NCI NIH HHS
• R35 CA220508 NCI NIH HHS
• U2C CA233284 NCI NIH HHS

• Chemotherapy
• Immunotherapy
• Pancreatic cancer
• Radiotherapy
• Surgery
• Targeted therapy
• Tumor microenvironment

• Humans
• Pancreatic Neoplasms/therapy
• Pancreatic Neoplasms/drug therapy
• Antineoplastic Combined Chemotherapy Protocols/therapeutic use
• Immunotherapy/methods
• Consensus
• Neoadjuvant Therapy/methods
• Chemotherapy, Adjuvant/methods

• 82303740 National Natural Science Foundation of China
• 2023YFS0167 Science and Technology Department of Sichuan Province
• P30 CA006973 NCI NIH HHS
• P01 CA247886 NCI NIH HHS
• P01 CA247886 NIH HHS
• R01 CA197296 NIH HHS
• R01 CA169702 NIH HHS
• 82403318 National Natural Science Foundation of China
• 2024HXBH134 Postdoctor Research Fund of West China Hospital, Sichuan University
• P30 CA006973. NIH HHS
• 2023T160451 China Postdoctoral Science Foundation
• 2023HXBH053 Postdoctor Research Fund of West China Hospital, Sichuan University
• 2024NSFSC1949 Science and Technology Department of Sichuan Province
• P50 CA062924 NIH HHS
• National Institutes of Health

• Neoadjuvant therapy
• Neoplasm recurrence, Local
• Neoplasm staging
• Pancreatic carcinoma
• Patient care team

• Anal
• Biliary
• Canal anal
• Cancer
• Estomac
• Gastric
• Hépatocarcinome
• Irradiation stéréotaxique
• Liver
• Metastasis
• Métastase
• Oesophageal
• Oligometastasis
• Oligométastase
• Pancreatic
• Pancréas
• Rectal
• Rectum
• Stereotactic body radiotherapy
• Synchrone
• Synchronous
• Voies biliaires
• Œsophage

• Humans
• Prospective Studies
• Gastrointestinal Neoplasms/radiotherapy
• Radiosurgery

• Humans
• Abdominal Neoplasms
• Pancreas/pathology
• Pancreatic Neoplasms/diagnosis
• Pancreatic Neoplasms/surgery

• MR/N025989/1 Medical Research Council

• Humans
• Pancreatic Neoplasms/diagnosis
• Pancreatic Neoplasms/therapy
• Combined Modality Therapy
• Treatment Outcome
• Antineoplastic Combined Chemotherapy Protocols/therapeutic use
• Forecasting

• R01 DE028529 NIDCR NIH HHS
• R01 DE028282 NIDCR NIH HHS
• R01 CA284651 NCI NIH HHS
• P50 CA261605 NCI NIH HHS

• Humans
• Pancreatic Neoplasms/diagnosis
• Neoplasm Metastasis

• pancreatic cancer
• prognosis
• therapy

• Humans
• Pancreatic Neoplasms/drug therapy
• Pancreatic Neoplasms/pathology
• Antineoplastic Combined Chemotherapy Protocols/therapeutic use
• Deoxycytidine/therapeutic use
• Carcinoma, Pancreatic Ductal/drug therapy
• Paclitaxel/therapeutic use
• Pancreas/pathology
• Oncologists

Pancreatic adenocarcinoma is a highly aggressive malignancy that presents a considerable risk of early death (survival time ≤ 3 mo). As such, it is of great significance to develop an effective nomogram for predicting the likelihood of early death in patients with metastatic pancreatic adenocarcinoma.

To construct and validate a predictive nomogram model for early death in patients with metastatic pancreatic adenocar-cinoma.

We extracted data from the SEER database of 18603 eligible patients with metastatic pancreatic adenocarcinoma from 2010 to 2015, and randomly divided them into training and validation cohorts in a 7:3 ratio. Univariate and multivariate logistic regression analyses were performed on the training cohort to identify the risk factors for early death, based on which a nomogram was constructed. The performance of the nomogram was verified by receiver operating characteristic (ROC) curve and calibration curve analyses in both the training and validation cohorts. The clinical practicability of the nomogram was evaluated by decision curve analysis (DCA).

Age, sex, primary site, grade, T stage, N stage, brain metastasis, bone metastasis, liver metastasis, lung metastasis, surgery, radiotherapy, and chemotherapy were identified as independent risk factors for early death in patients with metastatic pancreatic adenocarcinoma. Based on these variables, a nomogram was constructed. The areas under the ROC curves of the nomogram in the training and validation cohorts were 0.810 (95% confidence interval [CI]: 0.802-0.811) and 0.802 (95%CI: 0.790-0.813), respectively, indicating good discrimination. The calibration curves showed good calibration degrees in both cohorts, and the DCA results demonstrated that the nomogram had better clinical net benefit in predicting early mortality compared with TNM stage.

The constructed nomogram has good predictive ability for early death in patients with metastatic pancreatic adeno-carcinoma. This will help clinicians develop individualized treatment plans for these patients.

• Pancreatic adenocarcinoma
• SEER
• Nomogram
• Early death

• hepatopancreatobiliary surgery
• image-guided surgery
• intraoperative imaging
• targeted imaging

• R01 CA205941 NCI NIH HHS
• R01CA205941 NCI NIH HHS
• U54CA118949 NCI NIH HHS
• R01 EB034731 NIBIB NIH HHS
• f31ca261044 NCI NIH HHS
• p30ca225520 NCI NIH HHS
• R01EB034731 NCI NIH HHS
• F31 CA261044 NCI NIH HHS
• P30 CA225520 NCI NIH HHS

Pancreatic adenocarcinoma (PDAC) is one of the most common and lethal human cancers worldwide. Surgery followed by adjuvant chemotherapy offers the best chance of a long-term survival for patients with PDAC, although only approximately 20% of the patients have resectable tumors when diagnosed. Neoadjuvant chemotherapy (NACT) is recommended for borderline resectable pancreatic cancer. Several studies have investigated the role of NACT in treating resectable tumors based on the recent advances in PDAC biology, as NACT provides the potential benefit of selecting patients with favorable tumor biology and controls potential micro-metastases in high-risk patients with resectable PDAC. In such challenging cases, new potential tools, such as ct-DNA and molecular targeted therapy, are emerging as novel therapeutic options that may improve old paradigms. This review aims to summarize the current evidence regarding the role of NACT in treating non-metastatic pancreatic cancer while focusing on future perspectives in light of recent evidence.

• Pancreatic cancer
• Pancreatic duct adenocarcinoma
• Neoadjuvant chemotherapy
• Borderline resectable
• Locally advanced pancreatic cancer

Resection of initially oligometastatic pancreatic ductal adenocarcinoma (PDAC) following response to first-line chemotherapy is controversial. We herein updated a previous case series to investigate the oncologic outcomes and preoperative factors that could drive the decision-making process.

This retrospective analysis was limited to patients with liver-only synchronous metastases who experienced complete regression of the metastatic component and underwent pancreatectomy between October 2008 and July 2020 at two high-volume institutions. Clinical-pathologic variables were captured, and inflammation-based prognostic scores were calculated. Recurrence and survival analyses were performed using standard statistical methods.

Overall, 52 patients were included. FOLFIRINOX was the most employed chemotherapy regimen (63.5%). Post-treatment tumor size, serum carbohydrate antigen (CA) 19-9 and carcinoembryonic antigen (CEA) were significantly decreased relative to baseline evaluation. The median time from diagnosis to pancreatectomy was 10.2 months, while the median time from chemotherapy completion to pancreatectomy was 2 months. Major postoperative complications occurred in 26.9% of patients, while postoperative mortality was nil. The median disease-free survival (DFS) and overall survival (OS) from pancreatectomy were 16.5 and 23.0 months, respectively, and the median OS from diagnosis was 37.2 months. At multivariable analysis, vascular resection, operative time, prognostic nutrition index (PNI) and neutrophil-to-lymphocyte ratio (NLR) were associated with OS. Operative time, platelet × neutrophil/lymphocyte count (SII), and PNI were associated with DFS.

We confirm promising outcomes of selected patients who underwent pancreatectomy following downstaging of liver metastases. The absence of vascular involvement of the primary tumor, good nutritional status, and low inflammatory index scores could be useful to select candidates for resection.

• Liver resection
• Metastasis
• Multimodal treatment
• Prognosis
• Tumors

• Combined Modality Therapy
• Hepatectomy
• Humans
• Liver Neoplasms/therapy
• Treatment Outcome

• Adenocarcinoma/drug therapy
• Adenocarcinoma/surgery
• Carcinoma, Pancreatic Ductal/pathology
• Carcinoma, Pancreatic Ductal/surgery
• Humans
• Liver Neoplasms/pathology
• Liver Neoplasms/surgery
• Neoplasm Staging
• Pancreatic Neoplasms/drug therapy
• Pancreatic Neoplasms/surgery
• Prospective Studies
• Retrospective Studies
• Pancreatic Neoplasms

• Humans
• Pancreatectomy
• Pancreatic Neoplasms
• Pancreatic Neoplasms

• maintenance therapy
• next-generation sequencing
• pancreatic ductal adenocarcinoma (PDAC)
• targeted therapy

Background: The modern concept of oligometastatic (OM) state has been initially developed to describe patients with a low burden of disease and with a potential for cure with local ablative treatments. We systematically assessed the risk of death and relapse of oligometastatic (OM) cancers compared to cancers with more diffuse metastatic spread, through a meta-analysis of published data. 

Methods: PubMed, the Cochrane Library, and EMBASE were searched for studies reporting prognosis of patients with OM solid tumors. Risk of death and relapse were extracted and pooled to provide an adjusted hazard ratio with a 95% confidence interval (HR 95%CI).  The primary outcome of the study refers to overall mortality in OM vs. polymetastatic (PM) patients. 

Results. Mortality and relapse associated with OM state in patients with cancer were evaluated among 104,234 participants (n=173 studies). Progression-free survival was better in patients with OM disease (hazard ratio [HR] = 0.62, 95% CI 0.57–0.68; P <.001; n=69 studies). Also, OM cancers were associated with a better overall survival (OS) (HR = 0.65, 95% CI 0.62-0.68; P<.01; n=161 studies). In colorectal (CRC), breast, non-small cell lung cancer (NSCLC) and renal cell carcinoma (RCC) the reduction in the risk of death for OM patients were 35, 38, 30 and 42%, respectively. Biliary tract and cervical cancer do not significantly better in OM stage likely for paucity of data.

Conclusions. Patients with OM cancers have a significantly better prognosis than those with more widespread stage IV tumors. In OM cancer patients a personalized approach should be pursued.

• Carcinoma, Non-Small-Cell Lung
• Humans
• Lung Neoplasms
• Neoplasm Recurrence, Local
• Prognosis

Pancreatic adenocarcinoma (PCa) is a highly aggressive malignancy with high risk of early death (survival time ≤3 months). The present study aimed to identify associated risk factors and develop a simple-to-use nomogram to predict early death in metastatic PCa patients.

Patients diagnosed with metastatic PCa between 2010 and 2015 from the Surveillance, Epidemiology, and End Results (SEER) database were collected for model construction and internal validation. An independent data set was obtained from China for external validation. Independent risk variables contributed to early death were identified by logistic regression models, which were then used to construct a nomogram. Internal and external validation was performed to evaluate the nomogram using calibration curves and the receiver operating characteristic curves.

A total of 19,464 patients in the SEER cohort and 67 patients in the Chinese cohort were included. Patients from the SEER database were randomly divided into the training cohort (n = 13,040) and internal validation cohort (n = 6,424). Patients in the Chinese cohort were selected for the external validation cohort. Overall, 10,484 patients experienced early death in the SEER cohort and 35 in the Chinese cohort. A reliable nomogram was constructed on the basis of 11 significant risk factors. Internal validation and external validation of the nomogram showed high accuracy in predicting early death. Decision curve analysis demonstrated that this predictive nomogram had excellent and potential clinical applicability.

The nomogram provided a simple-to-use tool to distinguish early death in patients with metastatic PCa, assisting clinicians in implementing individualized treatment regimens.

• SEER database
• early death
• nomogram
• pancreatic adenocarcinoma
• prognosis

• cancer
• meta-analysis
• oligometastases
• review
• survival
• tumours

• Carcinoma, Non-Small-Cell Lung
• Humans
• Lung Neoplasms
• Neoplasm Recurrence, Local
• Prognosis