Systemic Chemotherapy With or Without Hepatic Arterial Infusion Chemotherapy for Liver Metastases From Pancreatic Cancer: A Propensity Score Matching Analysis

Whether systemic chemotherapy combined with hepatic arterial infusion chemotherapy was superior to chemotherapy alone in the treatment of pancreatic adenocarcinoma with liver metastases remains unclear. In this retrospective study, after appropriate propensity score matching, the survival of patients in the combi-nation group was significantly longer than that of patients in the chemotherapy group, this conclusion is worthy of further validation. Background: The significance of systemic chemotherapy (SCT) combined with hepatic arterial infusion (HAI) chemotherapy in the treatment of pancreatic ductal adenocarcinoma with liver metastases (PACLM) remains unclear. Based on previous studies, this single-center propensity score matching (PSM) study aimed to explore the efficacy of SCT with or without HAI for PACLM. Patient and Methods: The PSM method was used to screen 661 cases of PACLM who received SCT at Tianjin Medical University Cancer Institute and Hospital from 2001 to 2020. According to the 1:6 ratio with PSM, 385 patients were divided into the SCT + HAI group (n = 55) and the SCT group (n = 330). After a median follow-up of 49 (range 7-153) months, overall survival (OS) and survival-related prognostic factors were analyzed. Results: The main baseline characteristics of the SCT + HAI group and the SCT alone group were matched appropriately ( P > .05). After PSM, the median OS for patients in the 2 groups was 10.6 and 7.6 months, respectively ( P = .02). Multivariate analysis revealed that peritoneal metastases ( P = .03), CA199 > 500U/mL ( P = .03), and lactate dehydrogenase (LDH) > 250U/L ( P = .03) were prognostic factors of poor survival, modern SCT plus HAI ( P = .04) was a protective factor. Conclusion: Our findings indicated that adequate cycles of SCT + HAI result in better survival than SCT alone in patients with PACLM. Patients with peritoneal metastases, markedly elevated CA19-9 and LDH have a poorer prognosis. The conclusion has yet to be validated in randomized controlled clinical trials.