Does Recurrent Pancreatic Cancer Have Similar Outcomes Compared With Primary Metastatic Pancreatic Cancer?

[BACKGROUND AND OBJECTIVES] The survival difference between recurrent pancreatic cancer (Rec-PC) and primary metastatic PC (PM-PC) remains inadequately understood.

[METHODS] Eligible participants received combination chemotherapy with either gemcitabine plus nab-paclitaxel (GnP) or FOLFIRINOX. Overall survival (OS) was compared between patients with Rec-PC and those with PM-PC.

[RESULTS] Data from 147 participants (84 male and 63 female) were retrospectively analyzed. The Rec-PC group demonstrated significantly longer OS (median: 12.7 months) than the PM-PC group (median: 8.4 months) (p = 0.03). On multivariate analysis, Rec-PC (hazard ratio [HR]: 0.51; 95% confidence interval [CI]: 0.31-0.84; p < 0.01), presence of peritoneal dissemination (HR: 2.29; 95% CI: 1.42-3.69; p < 0.01), receipt of second-line chemotherapy (HR: 0.34; 95% CI: 0.21-0.55; p < 0.01), receipt of any local therapy (HR: 0.42; 95% CI: 0.23-0.77; p < 0.01), and prognostic nutritional index < 40 (HR: 2.50; 95% CI: 1.55-4.04; p < 0.01) were identified as independent prognostic factors.

[CONCLUSIONS] Rec-PC was identified as a favorable prognostic factor after adjusting for established prognostic indicators (registration number: NCT06921252).