Burden of liver metastases among pancreatic cancer patients in the United States.

Abstract

e16160 Background: Liver metastasis is a common and severe complication in pancreatic cancer, contributing significantly to morbidity and mortality. Despite therapeutic advances, the burden remains substantial. This study examines mortality trends, disparities, and geographic variation using CDC WONDER data. Methods: We accessed the CDC WONDER database (1999–2023) to identify individuals who died from liver metastasis (ICD-10: C78.7) among pancreatic cancer patients (ICD-10: C25.0 to C25.9). Mortality disparities were examined by year, sex, race/ethnicity, and geography. Joinpoint regression was used to estimate the average annual percentage change (AAPC) and annual percentage change (APC), with 95% confidence intervals (CIs). Results: A total of 65,939 deaths were related to liver metastasis among pancreatic cancer patients. Most deaths occurred in the 65–85+ year age group (45,323) and at the decedent’s home (51.8%). Overall, the AAMR increased from 0.97 (95% CI: 0.92 to 1.01) in 1999 to 1.97 (95% CI: 1.92 to 2.02) in 2023 (AAPC: 3.00; 95% CI: 2.33 to 3.66; p<0.001). The trend initially declined from 1999 to 2008 (APC = -3.28; 95% CI: -3.91 to -2.65; p<0.001), followed by a significant upward trajectory until 2023 (APC = 5.68; 95% CI: 4.93 to 6.42; p<0.001). The increase in mortality was slightly more pronounced in women than in men (AAPC: 3.03% vs. 2.89%). The highest incidence rates were observed among non-Hispanic (NH) Black or African Americans, followed by NH Whites and Hispanic/Latino populations. Geographic disparities were evident, with the South experiencing the greatest impact and the Northeast the lowest. Rural regions consistently showed higher AAMRs compared to urban areas. From 1999 to 2023, California recorded the highest number of deaths (7,765), while Alaska reported the lowest. Conclusions: Mortality from liver metastasis in pancreatic cancer patients has increased over the past two decades, with sharper increases in men. Persistent racial, geographic, and rural–urban disparities highlight the need for targeted interventions to achieve equitable outcomes and equity-focused healthcare strategies. Deaths and age-adjusted mortality rates (AAMRs) per 100,000 for trends related to liver metastasis with pancreatic cancer from 1999 to 2023. Variable Deaths AAMR (95%CI) 1999 AAMR (95% CI)2023 Overall 65,939 0.97(0.92 to 1.01) 1.97(1.92 to 2.02) Male 35,479 1.17(1.10 to 1.25) 2.31 (2.22 to 2.39) Female 30,460 0.81 (0.76 to 0.87) 1.70 (1.63 to 1.77) NH Whites 50,964 0.98 (0.93 to 1.03) 2.07 (2.01 to 2.14) NH Blacks 7,533 1.32 (1.14 to 1.51) 2.20 (2.03 to 2.37) South 26,210 0.99 (0.91 to 1.06) 2.10 (2.02 to 2.19) Northeast 9,227 1.05 (0.94 to 1.15) 1.39 (1.28 to 1.49) Urban 40,915 (2020) 0.95 (0.90 to 1.00) (2020) 1.66 (1.61 to 1.72) Rural 9,299 1.03 (0.92 to 1.14) 1.85 (1.72 to 1.98)