Metastasis-induced acute pancreatitis in lung cancer

Lung cancer complicated by metastasis-induced acute pancreatitis (MIAP) is rare and bears a poor prognosis. Information regarding the results of treatment and possible prognostic factors in patients with this clinical setting is limited. The records of 33 patients treated between 1976 and 2003 for histologically confirmed lung cancer complicated by MIAP were reviewed. The relevance of the interval from diagnosis of lung cancer to the occurrence of MIAP; Karnofsky performance status (KPS); white blood cell (WBC) count; levels of lactate dehydrogenase (LDH), glucose, amylase, and lipase; Ranson's score; and the duration of high amylase levels and chemotherapy to survival since MIAP were determined by univariate analysis, and their independent significance tested by multivariate analysis. Survival rates were calculated using the Kaplan-Meier method and the log-rank test. In the univariate analysis, the time interval to MIAP (P=.0484), the KPS (P=.0032), the duration of high amylase levels (P=.007), and length of chemotherapy after diagnosis of MIAP (P=.002) were significant predictors of overall survival. Ranson's score could not be used to predict clinical outcomes. Analysis of the current study indicated that duration of high amylase levels, the KPS when MIAP occurred, and the length of chemotherapy after diagnosis of MIAP are major determinants for overall survival in patients with MIAP complicated by lung cancer. These results may help to design a therapeutic approach in patients with MIAP complicated by lung cancer.