Influence of Metastatic Sites on Survival Outcomes and Predictive Factors for Extended Survival in Metastatic Pancreatic Cancer a Retrospective Study

Pancreatic cancer remains one of the most lethal malignancies worldwide, with a 5-year survival rate of less than 10%. The majority of patients are diagnosed at an advanced stage, and nearly 50% present with distant metastases at the time of diagnosis. Despite advances in chemotherapy, such as FOLFIRINOX and gemcitabine-based regimens, the prognosis of metastatic pancreatic cancer (mPC) remains extremely poor, with median overall survival typically ranging between 6 to 11 months. The pattern of metastasis in pancreatic cancer commonly involves the liver, peritoneum, lungs, and distant lymph nodes. Several studies suggest that the site and extent of metastatic disease may influence survival outcomes, although findings remain inconsistent. For example, liver metastases are frequently associated with worse prognosis, whereas isolated lung metastases may indicate a more indolent disease course. Understanding the prognostic significance of different metastatic sites may provide insight into disease biology and help guide clinical decision-making. In addition, identifying clinical and pathological factors associated with extended survival could inform treatment stratification, optimize resource allocation, and guide patient counseling. However, limited data exist regarding the predictors of long-term survival in mPC patients, particularly in real-world clinical settings. Therefore, this retrospective cohort study aims to investigate the influence of metastatic sites on overall survival and to identify potential predictive factors for extended survival among patients with metastatic pancreatic cancer. This information could contribute to more individualized prognostic assessments and potentially support the development of tailored therapeutic strategies.