Prognostic Significance of Number of Liver Metastases in Patients With Advanced Pancreatic Cancer Receiving Nab-paclitaxel Plus Gemcitabine.

BACKGROUND/AIM: The prognostic significance of the number of liver metastases in patients with advanced pancreatic cancer (APC) treated with nab-paclitaxel plus gemcitabine (AG) remains unclear. This study was performed to investigate the impact of the number of liver metastases on survival outcomes in this population. PATIENTS AND METHODS: From January 2015 to July 2024, 103 patients with APC received AG as first-line chemotherapy at Higashiosaka City Medical Center. The patients were categorized into three groups based on contrast-enhanced computed tomography findings: no liver metastases (NLM), several liver metastases (SLM) (1-9), and multiple liver metastases (MLM) (≥10). Overall survival (OS) was estimated using the Kaplan-Meier method and compared using the log-rank test. Patient characteristics and clinical courses were compared between the non-MLM and MLM groups. Prognostic factors were analyzed using Cox regression models. RESULTS: Fifty-two patients were assigned to the NLM group, 23 to the SLM group, and 28 to the MLM group. Median OS was significantly longer in the NLM group (12.0 months) than in the SLM group (9.9 months, p=0.012), whereas the MLM group had a significantly shorter median OS (4.6 months) than the NLM group (p<0.001). Multivariate analysis identified the number of liver metastases as an independent prognostic factor for OS. CONCLUSION: The number of liver metastases in patients with APC treated with nab-paclitaxel plus gemcitabine may help stratify prognosis in clinical practice and could serve as a useful parameter for treatment decision making and for stratification in future clinical trials.