■脑转移(BM)在胰腺导管腺癌(PDAC)中很少见,关于这些患者及其结局的数据很少。
■我们旨在分析管理,实践,以及在我们机构和文献报道的所有病例中,从PDAC提出BM的患者的结局。
■我们进行了回顾,使用数据挖掘工具(ConSoRe)进行单中心分析,以确定在我们的综合癌症中心(Paoli-Calmettes研究所)诊断为PDAC和BM的所有患者,从1997年7月到2022年6月(队列1)。同时,我们回顾并汇总了文献中PDAC和BM患者的病例报告和病例系列(队列2).描述每个队列中患者的临床特征,并使用Kaplan-Meier方法进行生存分析。
■在队列1中,19例(0.3%)PDAC和BM患者的中位年龄为69岁(范围:39-81)。大多数患者有转移性疾病(74%),包括BM的21%,在诊断。58%的患者存在肺转移。68%的患者有神经系统症状,68%的患者接受局灶性治疗(手术:21%,放射治疗:42%,伽玛刀放射外科:5%)。在队列2中,在文献中描述的61例患有BM的PDAC患者中,59%有转移性疾病,包括13%的BM在诊断。36%的患者存在肺转移,BM治疗包括:手术(36%),放射治疗(36%),放射外科(3%),或没有局部治疗(25%)。胰腺癌确诊后,在队列1中,发生BM的中位时间为7.8个月(范围:0.0~73.9),在队列2中为17.0个月(范围:0.0~64.0).队列1和队列2患者的中位总生存期(OS)为2.9个月(95%CI[1.7,4.0])和12.5个月(95%CI[7.5,17.5]),分别。
■BM在PDAC中非常罕见,似乎更常见于患有肺转移和更惰性疾病的年轻患者。BM与不良预后相关,神经外科手术提供了最好的结果,应在可行时予以考虑。
UNASSIGNED: Brain metastases (BM) are rare in pancreatic ductal adenocarcinoma (PDAC) and little data exists concerning these patients and their outcomes.
UNASSIGNED: We aimed to analyze the management, practices, and outcomes of patients presenting BM from PDAC both in our institution and in all cases reported in the literature.
UNASSIGNED: We conducted a retrospective, monocentric analysis using a data mining tool (ConSoRe) to identify all patients diagnosed with PDAC and BM in our comprehensive cancer center (Paoli-Calmettes Institute), from July 1997 to June 2022 (cohort 1). Simultaneously, we reviewed and pooled the case reports and case series of patients with PDAC and BM in the literature (cohort 2). The clinical characteristics of patients in each cohort were described and survival analyses were performed using the Kaplan-Meier method.
UNASSIGNED: In cohort 1, 19 patients (0.3%) with PDAC and BM were identified with a median age of 69 years (range: 39-81). Most patients had metastatic disease (74%), including 21% with BM, at diagnosis. Lung metastases were present in 58% of patients. 68% of patients had neurological symptoms and 68% were treated by focal treatment (surgery: 21%, radiotherapy: 42%, Gamma Knife radiosurgery: 5%). In cohort 2, among the 61 PDAC patients with BM described in the literature, 59% had metastatic disease, including 13% with BM at diagnosis. Lung metastases were present in 36% of patient and BM treatments included: surgery (36%), radiotherapy (36%), radiosurgery (3%), or no local treatment (25%). After the pancreatic cancer diagnosis, the median time to develop BM was 7.8 months (range: 0.0-73.9) in cohort 1 and 17.0 months (range: 0.0-64.0) in cohort 2. Median overall survival (OS) in patients of cohort 1 and cohort 2 was 2.9 months (95% CI [1.7,4.0]) and 12.5 months (95% CI [7.5,17.5]), respectively.
UNASSIGNED: BM are very uncommon in PDAC and seem to occur more often in younger patients with lung metastases and more indolent disease. BM are associated with poor prognosis and neurosurgery offers the best outcomes and should be considered when feasible.