{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T15:58:33Z","timestamp":1784563113847,"version":"3.55.0"},"reference-count":25,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2023,3,14]],"date-time":"2023-03-14T00:00:00Z","timestamp":1678752000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["KL2TR002552"],"award-info":[{"award-number":["KL2TR002552"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2023,5]]},"abstract":"Abstract<\/jats:title>Introduction<\/jats:title>Pancreatic ductal adenocarcinoma (PDAC) is a genetically heterogeneous disease often diagnosed with synchronous metastatic disease involving the liver. Tumors with extra\u2010abdominal spread that bypass the liver are thought to represent a unique molecular subgroup and those with isolated pulmonary metastatic disease are thought to have a more favorable clinical phenotype.<\/jats:p><\/jats:sec>Method<\/jats:title>We conducted a retrospective review of patients with pathologically confirmed PDAC treated between the years 2007 and 2020 at a Scripps Health hospital. The final study sample (N<\/jats:italic>\u00a0=\u00a0205) included patients with isolated pulmonary metastasis (IL), isolated liver metastasis or synchronous liver and lung metastasis (LL), or metastasis to any site other than the liver or lung (NLL). Primary endpoint was overall survival (OS). Progression\u2010free survival (PFS) and recurrence\u2010free survival (RFS) were analyzed as secondary endpoints. Each survival outcome was analyzed using Cox proportional hazards tests.<\/jats:p><\/jats:sec>Results<\/jats:title>No statistically significant differences were seen between the three groups in OS<\/jats:styled-content>, PFS,<\/jats:styled-content> or RFS<\/jats:styled-content>. Median OS<\/jats:styled-content> for the IL<\/jats:styled-content> group was 561\u2009days, 341\u2009days for the LL<\/jats:styled-content> group, and 441\u2009days for the NLL<\/jats:styled-content> group. Median RFS<\/jats:styled-content> was 748\u2009days for the IL<\/jats:styled-content> group, 574\u2009days for the LL<\/jats:styled-content> group, and 545\u2009days for the NLL<\/jats:styled-content> group. Median PFS<\/jats:styled-content> was 307 for the IL<\/jats:styled-content> group, 236 for the LL<\/jats:styled-content> group, and 265 for the NLL<\/jats:styled-content> group. When comparing only the IL<\/jats:styled-content> and LL<\/jats:styled-content> groups, a statistically significant difference in OS<\/jats:styled-content> was seen favoring the IL<\/jats:styled-content> group (HR1<\/jats:styled-content>.59 LL<\/jats:styled-content> vs IL<\/jats:styled-content> [ref<\/jats:italic>], CI<\/jats:styled-content> 1.04\u20132.41, p<\/jats:italic>\u00a0=\u20090.031)<\/jats:p><\/jats:sec>Conclusion<\/jats:title>Though statistically significant differences in survival outcomes were not seen in our population, there was a trend toward improved survival for patients with isolated lung metastases. When comparing only the IL to LL group, statistically significant overall survival favoring the IL group was seen. These findings highlight a potential prognostic indicator of metastatic PDAC.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cam4.5751","type":"journal-article","created":{"date-parts":[[2023,3,14]],"date-time":"2023-03-14T10:55:59Z","timestamp":1678791359000},"page":"10243-10253","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Do patients with metastatic pancreatic adenocarcinoma to the lung have improved survival?"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7304-2621","authenticated-orcid":false,"given":"Aren","family":"Ebrahimi","sequence":"first","affiliation":[{"name":"Department of Internal Medicine Scripps Clinic and Scripps Green Hospital La Jolla California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason","family":"Cham","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Scripps Clinic and Scripps Green Hospital La Jolla California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leah","family":"Puglisi","sequence":"additional","affiliation":[{"name":"Scripps Whittier Diabetes Institute, Scripps Health San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melanie","family":"De\u00a0Shadarevian","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Scripps Mercy Hospital San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David J.","family":"Hermel","sequence":"additional","affiliation":[{"name":"Department of Hematology and Oncology Scripps Clinic and Scripps MD Anderson Cancer Center La Jolla California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samantha R.","family":"Spierling\u00a0Bagsic","sequence":"additional","affiliation":[{"name":"Scripps Whittier Diabetes Institute, Scripps Health San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darren","family":"Sigal","sequence":"additional","affiliation":[{"name":"Department of Hematology and Oncology Scripps Clinic and Scripps MD Anderson Cancer Center La Jolla California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,3,14]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)30974-0"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21708"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.14740\/wjon1166"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v27.i27.4298"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41568-021-00418-1"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)32409-6"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1809775"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejso.2020.06.013"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers13174451"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2018-317163"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12029-018-0073-8"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.21778"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12885-018-4679-9"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.11295"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-017-4068-6"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm8091402"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.3390\/genes11010006"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000002234"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11605-011-1605-8"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-012-2762-z"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejso.2016.10.023"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00595-019-01902-w"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.4251\/wjgo.v7.i12.375"},{"key":"e_1_2_12_25_1","unstructured":"National Comprehensive Cancer Network.Pancreatic Adenocarcinoma. 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