Yasuo Shima1, Takehiro Okabayashi2, Akihito Kozuki2, Tatsuaki Sumiyoshi2, Teppei Tokumaru2, Yuichi Saisaka2, Keiichi Date2, Jun Iwata3. 1. Department of Gastroenterological Surgery, Kochi Health Sciences Center, 2125-1 Ike, Kochi, 781-8555, Japan. yasuo_shima@khsc.or.jp. 2. Department of Gastroenterological Surgery, Kochi Health Sciences Center, 2125-1 Ike, Kochi, 781-8555, Japan. 3. Department of Diagnostic Pathology, Kochi Health Sciences Center, Kochi, Japan.
Abstract
PURPOSE: There are no accepted surgical strategies for the treatment of pancreatic cancer recurrence in the remnant pancreas after initial resection. We retrospectively analyzed our experiences with patients undergoing completion pancreatectomy for recurrent pancreatic cancer in the remnant pancreas. METHODS: Six patients with recurrent pancreatic cancer in the remnant pancreas underwent completion pancreatectomy between March 2005 and December 2012. Operative, postoperative, and pathological data and long-term outcomes for these six patients were analyzed retrospectively. RESULTS: There was no operative morbidity or mortality associated with completion pancreatectomy. The median survival times were 49.0 and 27.5 months after initial resection and second pancreatectomy, respectively. However, all six patients died during follow-up. Five patients had recurrent pancreatic cancer at the time of death. One patient had no recurrence but had poor blood sugar control and eventually died after repeated bouts of cholangitis. CONCLUSIONS: Completion pancreatectomy is a safe and effective option in select patients with local pancreatic cancer recurrence in the remnant pancreas after initial pancreatectomy. It is essential to select patients who have a good performance status and can tolerate major surgery and the resultant apancreatic state.
PURPOSE: There are no accepted surgical strategies for the treatment of pancreatic cancer recurrence in the remnant pancreas after initial resection. We retrospectively analyzed our experiences with patients undergoing completion pancreatectomy for recurrent pancreatic cancer in the remnant pancreas. METHODS: Six patients with recurrent pancreatic cancer in the remnant pancreas underwent completion pancreatectomy between March 2005 and December 2012. Operative, postoperative, and pathological data and long-term outcomes for these six patients were analyzed retrospectively. RESULTS: There was no operative morbidity or mortality associated with completion pancreatectomy. The median survival times were 49.0 and 27.5 months after initial resection and second pancreatectomy, respectively. However, all six patients died during follow-up. Five patients had recurrent pancreatic cancer at the time of death. One patient had no recurrence but had poor blood sugar control and eventually died after repeated bouts of cholangitis. CONCLUSIONS: Completion pancreatectomy is a safe and effective option in select patients with local pancreatic cancer recurrence in the remnant pancreas after initial pancreatectomy. It is essential to select patients who have a good performance status and can tolerate major surgery and the resultant apancreatic state.
Entities:
Keywords:
Local neoplasm recurrence; Pancreatectomy; Pancreatic cancer; Surgery
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