Cardillo N, et al. - Researchers used a retrospective cohort of patients with pancreatic cancer to characterize the complications and hospitalizations from local vs distant disease progression. They found that local tumor progression in pancreatic cancer patients resulted in significant complications, so local therapies, not just distant disease progression, should be a focus of future study.

Methods

• Researchers retrospectively reviewed records of 298 cases of pancreatic cancer treated at a single institution from 2004 through 2015, and recorded cancer-related symptoms and complications requiring hospitalization.
• Either local or distant progression- related hospitalizations of pancreatic cancer patients were recorded.
• Cumulative incidence analyses and multivariable Fine-Gray regression models were used to estimate the incidence of hospitalization and to identify aspects predictive of hospitalizations, respectively.

Results

• The documented 1-year cumulative incidences of hospitalization due to local vs distant disease progression were 31% and 24%, respectively.
• Cholangitis (10%), biliary obstruction (7%), local procedure complication (7%), and gastrointestinal bleeding (7%) were the leading local etiologies reported in 509 recorded hospitalizations.
• The significant predictors of hospitalization from local progression, as revealed in multivariable analysis, included unresectable disease (subdistribution hazard ratio [SDHR], 2.42; P < .01), black race (SDHR, 3.34; P <. 01), younger age (SDHR, 1.02 per year; P=.01), tumor in the pancreatic head (SDHR, 2.19; P <. 01), and larger tumor size (SDHR, 1.13 per centimeter; P=.02).
• Findings revealed that among patients who died in the hospital from pancreatic cancer (56%), mostly were admitted for complications of local disease progression.