Smoking Status And Treatment Outcome In Patients With Pancreatic Cancer.

e15676 Background: Tobacco smoking is a recognized risk factor for pancreatic cancer (PC). The aim of the study was to characterize clinical features, treatment, molecular abnormalities and survival of patients with PC in relation to smoking status. Methods: Data for 299 patients with PC diagnosed and/or treated in the Princess Margaret Cancer Center/University Health Network between 2008-2015 was obtained retrospectively from the electric patient records. Results: There were 141 females (47%), 158 males (53%), median age was 64 years (range: 28-89). Median follow-up was 12.2 months (range: 0.8-82.4). The majority of patients were never smokers (50%) followed by ex- (38%) and current smokers (12%). Of all the patients with known family history, 11% had a history of PC. Among 182 patients with known BRCA status, 14% had germline mutations. Most patients had adenocarcinoma (98%) and presented in stage IV (40%), followed by locally advanced (LO) unresectable (30%) and LO resectable (30%) disease. Smoking did not impact stage at diagnosis. Overall survival (OS) did not differ between never-, ex- and current smokers, with one year OS rates of 51%, 55% and 55%. Smoking pack years was not significantly associated with survival. Smoking was associated with male sex (p = 0.0053), higher body surface area (BSA) (p = 0.00063), and being a BRCA carrier (p = 0.01). Never smokers were more likely to have experienced weight loss at diagnosis (p = 0.027). In multivariable analysis old age ( > 64 vs. < 64; HR = 1.34; 95% CI: 1.01-1.8; p = 0.045) and poor performance status (ECOG 2-3 vs. 0; HR = 1.92; 95% CI: 1.24-3; p = 0.0038)were associated with poorer survival. Metastatic (vs. resectable) disease at diagnosis was associated with poorer survival, however the effect was largest in early follow-up and diminished with time (HR = 6.88, 95% CI: 3.35-14.14; p < .0001, with time HR = 0.95, 95% CI: 0.91-1, p = 0.031).After adjusting for age, BSA, ECOG and stage at diagnosis, smoking status was not significantly associated with survival (HR = 0.89; 95% CI = 0.67-1.18; p = 0.43). Conclusions: Smoking status does not affect treatment outcome in patients with pancreatic adenocarcinoma. Association of germline BRCA and smoking warrants validation studies.