Prognostic analysis of asynchronous liver metastasis in patients with pancreatic cancer

Objective To analyse tratment strategies and to evaluate the relation between different therapies and survival rate of patients of with asynchronous liver metastases after pancreatic cancer surgery(PCLM). Methods From January 2006 to January 2012, 48 patients with PCLM were included in this study, and their medical records were retrospectively analyzed. Results Among the 48 patients, 27 cases of liver metastases were found within six months after surgery, and the survival rate for 1, 3 and 5 years was 22.2%, 3.7% and 0%, respectively, with the median survival of 6 months, and 21 cases of liver metastases were found after six months, and the survival rate for 1, 3 and 5 years was 85.7%, 30.6% and 9.2%, with the median survival of 15 months, and the difference between the two groups was statistically significant (P<0.01). After pancreatic cancer surgery and adjuvant gemcitabine chemotherapy, the probability of liver metastases was 33.3%(8/24) within six months, the median disease-free survival time was 8 months and the disease-free survival rate for 1, 3 and 5 years was 20.8%, 4.3% and 0%. For patients without adjuvant gemcitabine chemotherapy, the probability of liver metastases was 79.2%(19/24), the median disease-free survival time was 3 months and the disease-free survival rate for 1, 3 and 5 years was 4.2%, 0% and 0%, and the difference between the two groups was statistically significant (P<0.01). The overall survival for patients undergoing resection of liver metastases combined with gemcitabine treatment was better than the other groups (P<0.01). And the overall survival for patients undergoing transhepatic arterial embolization (TACE) combined with gemcitabine treatment was better than TACE group, gemcitabine group or the observation group(P<0.05). There were no difference in overall survival between TACE group, gemcitabine group and observation group. Conclusions Pancreatic cancer patients who develop liver metastasis within six months after surgery have poor prognosis, but postoperative chemotherapy can delay the development of liver metastasis. For patients with resectable lesion, resection of asynchronous liver metastasis is the treatment of choice, and TACE combined with gemcitabine has better efficacy than that of single treatment. Key words: Pancreatic neoplasms; Liver metastasis; Postoperative period; Prognosis