Patient survival outcomes in brain metastases of pancreatic ductal adenocarcinoma: A comprehensive analysis

Background: Pancreatic ductal adenocarcinoma (PDAC) often presents with metastases. Brain metastases are rare, necessitating a thorough analysis of patient profiles and management. Methods: Patients with PDAC and brain metastases (2010–2021) were identified from the SEER database. PDAC-specific survival (PSS) was the primary outcome. Survival differences were assessed via Kaplan–Meier analysis, and prognostic factors via Cox regression. Results: This study included 113 patients with PDAC brain metastasis, and survival analysis was conducted on 78 eligible patients. The median PSS times were 6 months for brain metastases combined with lung metastases, 5 months for brain-only metastases, 3 months for brain metastases combined with bone metastases, 2 months for brain metastases combined with multiple metastases, and 1.5 months for brain metastases combined with liver metastases. Patients who received both radiotherapy and chemotherapy had better prognoses than those who had received radiotherapy only (P < 0.001, hazard ratio (HR) = 0.110). Other risk factors were combined with liver metastases (compared with only brain metastasis: P < 0.001, HR = 4.57) and a separated, divorced, or widowed marital status (compared with a married status: P = 0.038, HR = 2.029). Conclusions: Patients with PDAC brain metastases combined with liver metastases showed a significantly shorter median PSS time than those with brain metastases only. Patients who had received both chemotherapy and radiotherapy had longer median PSS time than those who had received radiotherapy only. A study with a large sample size is still required.