Haag Susan, Cridebring Derek
HonorHealth, Scottsdale Osborn Medical Center SOMC, Scottsdale, AZ, USA.
Molecular Medicine Division and Clinical Partner Relations, Translational Genomics Research Institute (TGen), Phoenix, AZ, USA.
Cancer Control. 2025 Jan-Dec;32:10732748251347844. doi: 10.1177/10732748251347844. Epub 2025 Jun 4.
IntroductionBrain metastasis (BM) is an inauspicious finding in patients with pancreatic cancer, which significantly increases morbidity and mortality. The presentation is rare, and thus, outcomes on brain metastases from pancreatic cancer are limited.MethodsThis retrospective monocentric analysis included the electronic medical records of patients ≥ 18 years presenting with BM from pancreatic cancer. Clinical, demographic, and overall survival (OS) data were analyzed. Brain imaging (computed tomography, and magnetic resonance imaging) was used for BM diagnosis. OS was calculated from the date of diagnosis to either the date of last follow-up or death. Cox regression on OS time was used with an indicator variable for patients who ultimately developed a BM.ResultsBrain metastases was diagnosed in 34 (3.7%) patients with pancreatic cancer treated in our institution. Of the BM patients: 7 (22%) were non-White; 16 (47%) were female; the median age was 69; 35% were diagnosed at Stage II and III; and 65% were diagnosed at Stage IV. BM was the first diagnosed metastasis in 14 (41%) of the patients; in 5 individuals (15%) BM were detected within the first 100 days of pancreatic cancer diagnosis. OS from BM diagnosis was 9 months (95% CI [6.92,17.86]). The adjusted hazard ratio for patients with BM was .91(95% CI [.88, .94]; = 0.60], which was not significant.ConclusionsDue to the low incidence of BM in pancreatic cancer, identification of disease remains a current challenge. In this study, we found that BM from pancreatic cancer may be the first sign that the cancer has spread. Using advanced neuroimaging early may help physicians diagnose these metastases sooner and possibly improve survival. With a larger cohort size, the findings may be potentially impactful for clinicians and patients. Prospective, multicentric studies are warranted to identify prognostic factors for treatment and survival.
引言
脑转移（BM）在胰腺癌患者中是一个不祥的发现，它会显著增加发病率和死亡率。其表现较为罕见，因此，关于胰腺癌脑转移的治疗结果有限。
方法
这项回顾性单中心分析纳入了年龄≥18岁的胰腺癌脑转移患者的电子病历。分析了临床、人口统计学和总生存期（OS）数据。使用脑部成像（计算机断层扫描和磁共振成像）进行脑转移诊断。OS从诊断日期计算至最后一次随访日期或死亡日期。对OS时间进行Cox回归分析，并将最终发生脑转移的患者作为指示变量。
结果
在我们机构接受治疗的胰腺癌患者中，有34例（3.7%）被诊断为脑转移。在脑转移患者中：7例（22%）为非白人；16例（47%）为女性；中位年龄为69岁；35%在II期和III期被诊断；65%在IV期被诊断。脑转移是14例（41%）患者首次诊断出的转移；5例（15%）患者在胰腺癌诊断后的前100天内检测到脑转移。从脑转移诊断开始的OS为9个月（95%CI[6.92,17.86]）。脑转移患者的调整后风险比为0.91（95%CI[0.88,0.94]；P = 0.60），无统计学意义。
结论
由于胰腺癌脑转移的发生率较低，疾病的识别仍然是当前的一项挑战。在本研究中，我们发现胰腺癌脑转移可能是癌症已经扩散的首个迹象。早期使用先进的神经影像学检查可能有助于医生更早地诊断这些转移灶，并可能改善生存期。样本量更大时，这些发现可能对临床医生和患者具有潜在影响。有必要开展前瞻性、多中心研究以确定治疗和生存的预后因素。
