Patterns of disease dissemination and survival in patients with synchronous and metachronous metastatic pancreatic adenocarcinoma: Nationwide population-based study

Merlijn U.J.E. Graus, Aniek E. van Diepen, Kim Josemanders, Marc G. Besselink, Stefan A.W. Bouwense, Lois A. Daamen, Ignace H. J. T. de Hingh, Evelien J.M. de Jong, Hanneke W.M. van Laarhoven, Vincent E. de Meijer, I Quintus Molenaar, Martijn W.J. Stommel, Liselot Valkenburg‐van Iersel, Johanna W. Wilmink, Lydia G. van der Geest, Judith de Vos‐Geelen

This nationwide population-based study reveals that metachronous-mPAC less commonly presents with liver metastases and more often metastasizes to lung, peritoneum or other atypical sites compared to synchronous-mPAC. These distinct metastatic patterns and their differences in survival may help enhance the prognostic estimation for individual patients from the detection of metastatic disease and warrants further research into the biology underlying metastasis development.