BACKGROUND/AIMS: The aim of this study was to evaluate patterns of the initial recurrence after pancreatectomy for pancreatic cancer and risk factors in each pattern. METHODOLOGY: This study included 209 pancreatic cancer patients who underwent pancreatectomy and of whom the detailed information on the first recurrent lesions detected by imaging during postoperative followup were available. Relapse patterns were classified into 4 groups: liver, peritoneal, local and extra-abdominal recurrences. We evaluated their associations with prognosis and various clinicopathological factors to identify relevant risk factors. RESULTS: Cumulative numbers of patients with liver, peritoneal, local, and extra-abdominal recurrences were 81, 70, 98 and 22, respectively, for the first recurrences. Hepatic relapse was associated with significantly shorter overall survival than other sites (p<0.001) and was an independent prognostic factor in multivariate analysis (p<0.001). Pathological portal vein invasion was the only independent risk factor for hepatic relapse (p=0.045). There was no significant correlation between the depth of invasion and prevalence of hepatic relapse. CONCLUSIONS: Hepatic relapse was associated with a dismal prognosis and with pathological portal vein invasion. Novel therapeutic strategies are therefore required to reduce the incidence of hepatic relapse, especially in patients with portal vein invasion.
BACKGROUND/AIMS: The aim of this study was to evaluate patterns of the initial recurrence after pancreatectomy for pancreatic cancer and risk factors in each pattern. METHODOLOGY: This study included 209 pancreatic cancerpatients who underwent pancreatectomy and of whom the detailed information on the first recurrent lesions detected by imaging during postoperative followup were available. Relapse patterns were classified into 4 groups: liver, peritoneal, local and extra-abdominal recurrences. We evaluated their associations with prognosis and various clinicopathological factors to identify relevant risk factors. RESULTS: Cumulative numbers of patients with liver, peritoneal, local, and extra-abdominal recurrences were 81, 70, 98 and 22, respectively, for the first recurrences. Hepatic relapse was associated with significantly shorter overall survival than other sites (p<0.001) and was an independent prognostic factor in multivariate analysis (p<0.001). Pathological portal vein invasion was the only independent risk factor for hepatic relapse (p=0.045). There was no significant correlation between the depth of invasion and prevalence of hepatic relapse. CONCLUSIONS: Hepatic relapse was associated with a dismal prognosis and with pathological portal vein invasion. Novel therapeutic strategies are therefore required to reduce the incidence of hepatic relapse, especially in patients with portal vein invasion.
Authors: Robert P Jones; Eftychia-Eirini Psarelli; Richard Jackson; Paula Ghaneh; Christopher M Halloran; Daniel H Palmer; Fiona Campbell; Juan W Valle; Olusola Faluyi; Derek A O'Reilly; David Cunningham; Jonathan Wadsley; Suzanne Darby; Tim Meyer; Roopinder Gillmore; Alan Anthoney; Pehr Lind; Bengt Glimelius; Stephen Falk; Jakob R Izbicki; Gary William Middleton; Sebastian Cummins; Paul J Ross; Harpreet Wasan; Alec McDonald; Tom Crosby; Yuk Ting; Kinnari Patel; David Sherriff; Rubin Soomal; David Borg; Sharmila Sothi; Pascal Hammel; Markus M Lerch; Julia Mayerle; Christine Tjaden; Oliver Strobel; Thilo Hackert; Markus W Büchler; John P Neoptolemos Journal: JAMA Surg Date: 2019-11-01 Impact factor: 14.766
Authors: Vincent P Groot; Georgios Gemenetzis; Alex B Blair; Roberto J Rivero-Soto; Jun Yu; Ammar A Javed; Richard A Burkhart; Inne H M Borel Rinkes; I Quintus Molenaar; John L Cameron; Matthew J Weiss; Christopher L Wolfgang; Jin He Journal: Ann Surg Date: 2018-03-23 Impact factor: 12.969
Authors: Vincent P Groot; Georgios Gemenetzis; Alex B Blair; Ding Ding; Ammar A Javed; Richard A Burkhart; Jun Yu; Inne H Borel Rinkes; I Quintus Molenaar; John L Cameron; Elliot K Fishman; Ralph H Hruban; Matthew J Weiss; Christopher L Wolfgang; Jin He Journal: Ann Surg Oncol Date: 2018-06-14 Impact factor: 5.344
Authors: Seung-Mo Hong; DongJun Jung; Ashley Kiemen; Matthias M Gaida; Tadashi Yoshizawa; Alicia M Braxton; Michaël Noë; Gemma Lionheart; Kiyoko Oshima; Elizabeth D Thompson; Richard Burkhart; Pei-Hsun Wu; Denis Wirtz; Ralph H Hruban; Laura D Wood Journal: Mod Pathol Date: 2019-11-07 Impact factor: 8.209
Authors: Vincent P Groot; Georgios Gemenetzis; Alex B Blair; Roberto J Rivero-Soto; Jun Yu; Ammar A Javed; Richard A Burkhart; Inne H M Borel Rinkes; I Quintus Molenaar; John L Cameron; Matthew J Weiss; Christopher L Wolfgang; Jin He Journal: Ann Surg Date: 2019-06 Impact factor: 13.787