Pattern of local recurrence after curative resection in pancreatic ductal adenocarcinoma according to the initial location of the tumor

Jae Ri Kim, Hongbeom Kim, Wooil Kwon, Jin Young Jang, Sun Whe Kim

Research output: Contribution to journalArticlepeer-review

Abstract

Background/Purpose: The aim of the present study was to identify the types of recurrence in pancreatic ductal adenocarcinoma (PDAC) and discover the frequent location of the local recurrence. Methods: This study included 361 patients with PDAC who underwent curative-intent surgery between 2007-2014. Results: Among 361 patients, 75.1% (n = 271) developed recurrence during the follow-up period. The 5-year overall survival rate of recurred patients was 8.3%. The patterns of recurrence were classified as local (17.7%), systemic (62.0%), and loco-systemic (20.3%). According to the preoperative tumor locations, patients with uncinate and head cancer showed higher rates of local recurrence than those with body and tail cancer (47.8% vs 17.2%, P <.001). When comparing uncinate and head cancer only, patients with uncinate cancer had much more frequent local recurrence around the superior mesenteric artery/vein (M zone) than around the hepatoduodenal ligament/common hepatic artery (H zone). Patients with head cancer had a higher rate of local recurrence in the H zone (H zone vs M zone; 53.5% vs 81.4% in uncinate cancer, P =.001; 66.7% vs 44.4% in head cancer, P =.056). Conclusion: Discovering the patterns of recurrence and frequent locations of recurrence may assist in local control as well as in the development of a customized individual approach for each patient.

Original languageEnglish
Pages (from-to)105-114
Number of pages10
JournalJournal of Hepato-Biliary-Pancreatic Sciences
Volume28
Issue number1
DOIs
StatePublished - Jan 2021

Keywords

  • neoplasm
  • pancreas
  • pancreatic neoplasm
  • pancreaticoduodenectomy
  • recurrence

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