Introduction: Little information is available concerning the prognosis and treatment of metastasis-induced acute pancreatitis (MIAP) with lung cancer. The aim of this study was to investigate the prognostic factors of MIAP patients with lung cancer.
Methods: A retrospective study of 20 MIAP patients with lung cancer was performed. Survival was estimated using Kaplan-Meier method. Prognostic factors were assessed with Cox proportional hazards regression model.
Results: There were 14 men and six women; 15 cases were non-small cell lung cancer and five cases were small cell lung cancer. The median age was 68 (range, 41-83). The mean duration from lung cancer to MIAP diagnosis of having MIAP was 139.8 days (range, 3-892). However, two small cell lung cancer cases had preceded presentation with acute pancreatitis. Chemotherapy (p = 0.008; hazards ratio = 4.99; 95% confidence interval = 1.51-16.54) and an Eastern Cooperative Oncology Group (ECOG) performance status (PS) (p = 0.007; hazards ratio = 6.13; 95% confidence interval = 0.04-0.61) were significant prognostic factors for survival. ECOG PS 3 to 4 at diagnosis of MIAP was 11/20. Survival of MIAP with lung cancer was 108.7 days. Patients with ECOG PS 3 to 4 had shorter mean survival than those with PS 0 to 2 (33.7 versus 226.4 days; p = 0.003). Chemotherapy group had longer mean survival than those without chemotherapy (161.9 versus 25.0 days; p = 0.01).
Conclusion: Chemotherapy can improve survival of MIAP from bronchogenic carcinoma in the selected patients.