3535 - Impact of Time to Treatment on the Development of Distant Metastasis in Localized Pancreatic Cancer: A Tertiary Care Center Experience.

Purpose/Objective(s):

Pancreatic cancer remains one of the more aggressive and lethal malignancies, with a propensity for recurrence even after treatment. This study investigates the relationship between temporal treatment dynamics and disease recurrence. The aim of this study was to evaluate whether the time from biopsy to the initiation of treatment impacts the development of recurrence or distant metastasis in patients with localized pancreatic cancer.

Materials/Methods:

A retrospective cohort study was conducted at a tertiary care center, analyzing data from a large departmental database (IRB approved) of 91 patients from 2016 to 2024 diagnosed with localized pancreatic cancer. Patients were included if they had a pathologic diagnosis of primary pancreatic adenocarcinoma and underwent treatment. Descriptive statistics were calculated for key time intervals. The Mann-Whitney U test was used to compare groups with and without recurrence for time from biopsy to initiation of treatment. Univariable logistic regression analysis was performed, and a Receiver Operating Characteristic (ROC) curve was constructed to evaluate the model's predictive accuracy. Statistical significance was determined at p < 0.05 using SAS version 9.4.

Results:

Of the 91 patients assessed, 43 (47%) were male and 48 (53%) were female. 53 (58%) of the patients experienced recurrence or distant metastasis, while 38 (42%) remained disease-free and without recurrent disease. Of the 91 patients, 40 patients (44%) were known to be deceased. There was no significant difference found in time to treatment from the initial biopsy between the 53 patients with recurrence (median 28 days) and the 38 patients without recurrence (median 29 days) (p = 0.8405). Among patients with recurrent disease, the median time from biopsy to recurrence was 464 days, and the median time from initiation of treatment to recurrent disease was 426 days. Univariable logistic regression analysis indicated that time from biopsy to treatment initiation was not a significant predictor of recurrence or distant metastasis (p = 0.534). The ROC curve for this model yielded an AUC of 0.487, indicating poor predictive performance, worse than random chance.

Conclusion:

This study found that the time interval from biopsy to treatment initiation does not significantly impact the development of recurrence or distant metastasis in patients with localized pancreatic adenocarcinoma. The similar median time to treatment between patients with and without recurrence, alongside the nonsignificant results from logistic regression and the ROC analysis, suggests that short delays in initiating treatment may not adversely affect patient outcomes.

These findings suggest that factors beyond time to treatment initiation may play a more critical role in the development of recurrent or metastatic disease. Further research with larger cohorts and multivariable analyses is needed to better understand the determinants of recurrence and survival in pancreatic cancer patients.