Upon multivariable analysis shown in Table 4, worse performance status (hazard ratio [HR] 1.81; P = 0.021), metastatic disease (HR 2.00; P = 0.012), higher CA 19-9 levels (HR 1.0001, P < 0.001), and mutations in IDH1 (HR 1.80; P = 0.042) and PIK3CA (HR 2.29; P = 0.034) continued to be associated with an increased risk of death. This evidence concerns the gene PIK3CA and metastatic neoplasm.