Selective reoperation after primary resection as a feasible and safe treatment strategy for recurrent pancreatic cancer

Local recurrence frequently occurs in patients with pancreatic cancer after intended curative resections. However, no treatment strategies have been established for isolated local recurrence. Several series have demonstrated a survival benefit for reoperation in selected pancreatic recurrence cases....

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Published in:Medicine (Baltimore) 2016-07, Vol.95 (30), p.e4191-e4191
Main Authors: Chang, Shih-Chun, Hsu, Chih-Po, Tsai, Chun-Yi, Liu, Yu-Yin, Liu, Keng-Hao, Hsu, Jun-Te, Yeh, Ta-Sen, Yeh, Chun-Nan, Hwang, Tsann-Long
Format: Article
Language:English
Subjects:
Adenocarcinoma - mortality
Adenocarcinoma - surgery
Adult
Aged
Aged, 80 and over
Disease-Free Survival
Female
Humans
Male
Middle Aged
Neoplasm Recurrence, Local - mortality
Neoplasm Recurrence, Local - surgery
Observational Study
Pancreatic Neoplasms - mortality
Pancreatic Neoplasms - surgery
Reoperation
Retrospective Studies
Taiwan - epidemiology
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Summary:Local recurrence frequently occurs in patients with pancreatic cancer after intended curative resections. However, no treatment strategies have been established for isolated local recurrence. Several series have demonstrated a survival benefit for reoperation in selected pancreatic recurrence cases. This study compares the difference in overall survival (OS) between surgery and nonsurgery groups in recurrent pancreatic cancer.All patients from 1990 to 2014 with recurrent pancreatic cancer who underwent curative resections were investigated and retrospectively reviewed. Clinicopathological features and OS were compared.A total of 332 patients were recruited in this series. The majority had histologically pancreatic adenocarcinoma (289 patients, 87.0%). Fourteen of 332 patients (4.2%) with recurrent pancreatic cancer received subsequent resection. Most of these patients underwent curative surgery (R0 resection, 13 patients, 92.9%), and only 1 patient (7.1%) had microscopic residual tumor (R1 resection). Disease-free survival (DFS), OS, and postrecurrence survival (PRS) were all significantly longer in the surgery group (DFS 10.6 vs 6.1 months, P = 0.044; OS 57.8 vs 14.0 months, P 
ISSN:0025-7974
1536-5964
DOI:10.1097/MD.0000000000004191