Prevalence and significance of subcentimeter hepatic lesions in patients with localized pancreatic adenocarcinoma

Shereef M. Elnahal, Atul B. Shinagare, Jackie Szymonifka, Theodore S. Hong, Peter C. Enzinger, Harvey J. Mamon
2012 Practical Radiation Oncology  
Objectives-To determine the prevalence and significance of incidental hepatic and pulmonary sub-centimeter lesions in patients with localized pancreatic cancer. Methods-This retrospective study included 101 patients treated for localized pancreatic adenocarcinoma from 1999 to 2007. Staging and follow-up imaging was reviewed to determine the frequency of sub-centimeter liver and pulmonary lesions. Using Cox regression, we calculated adjusted hazard ratios (HR) to determine the association
more » ... presence of liver and pulmonary lesions and overall survival. Results-Forty patients (39.6%) had sub-centimeter hepatic or pulmonary lesions on staging scans. Of these patients, 33 (82.5% of patients with lesions) had eventual metastases in the same organ as the lesions. Of this group, seven patients (17.5% of patients with lesions) eventually had a metastasis at the site of the original lesion. Liver lesions predicted the occurrence of metastatic disease to the liver compared to patients without lesions (67.7% with lesions vs. 44.4% without, p = .034). Sub-centimeter liver lesions at diagnosis were significantly associated with reduced overall survival (HR 1.65, p = 0.036). Conclusions-Sub-centimeter lesions in the liver and lung are common in patients with localized pancreatic cancer. The presence of indeterminate lesions may be associated with reduced overall survival.
doi:10.1016/j.prro.2012.02.004 pmid:24674191 pmcid:PMC4350367 fatcat:32omfmi2andhtpf5zoz4zq4iti