Jae Ri Kim1,2, Hongbeom Kim1, Wooil Kwon1, Jin-Young Jang1, Sun-Whe Kim1,3. 1. Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea. 2. Department of Surgery, Pusan National University Hospital, Busan, South Korea. 3. Center for Liver and Pancreatobiliary Cancer, National Cancer Center, Goyang, South Korea.
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.
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.
Authors: Gerard M Healy; Emmanuel Salinas-Miranda; Rahi Jain; Xin Dong; Dominik Deniffel; Ayelet Borgida; Ali Hosni; David T Ryan; Nwabundo Njeze; Anne McGuire; Kevin C Conlon; Jonathan D Dodd; Edmund Ronan Ryan; Robert C Grant; Steven Gallinger; Masoom A Haider Journal: Eur Radiol Date: 2021-11-10 Impact factor: 7.034