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Rapid Metastatic Recurrence After Pancreatic Cancer Resection: A Multi-center, Regional Analysis Of Trends In Surgical Failure Over Two Decades.

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Rapid Metastatic Recurrence After Pancreatic Cancer Resection: A Multi-center, Regional Analysis Of Trends In Surgical Failure Over Two Decades.

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Rapid metastatic recurrence after pancreatic cancer resection: a multi-center, regional analysis of trends in

Ranish K Patel¹, Gustavo Salgado-Garza¹, Thomas L Sutton¹

¹Oregon Health & Science University (OHSU), Department of Surgery, Portland, OR 97239, USA.

HPB : the Official Journal of the International Hepato Pancreato Biliary Association

|September 6, 2024

View abstract on PubMed

Summary

This summary is machine-generated.

Rapid recurrence of pancreatic cancer (PDAc) remains high. Surgical site infections and nodal positivity increase risk, while adjuvant therapy lowers it, highlighting a need for targeted prevention strategies.

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Area of Science:

Oncology
Surgical Oncology
Cancer Epidemiology

Background:

Pancreatic ductal adenocarcinoma (PDAc) is a highly lethal cancer.
High rates of rapid recurrence (rrPDAc) after surgery contribute to poor outcomes.
Understanding predictors of rrPDAc is crucial for improving patient survival.

Purpose of the Study:

To characterize recurrence rates over time in PDAc patients.
To identify factors associated with rapid recurrence (rrPDAc) following curative-intent resection.

Main Methods:

Utilized a multi-institutional cancer registry and the National Surgical Quality Improvement Program database.
Analyzed data from 924 patients who underwent PDAc resection between 1996 and 2020.
Defined rrPDAc as recurrence within 6 months post-surgery.

Main Results:

26% of patients experienced rrPDAc, with a median annual incidence of 25.3%.
rrPDAc significantly reduced median survival (10.3 months) compared to non-rapid recurrence (25.2 months) and no recurrence (56.1 months).
Surgical site infections (SSI) and nodal positivity were linked to increased rrPDAc risk; adjuvant therapy was associated with decreased risk.

Conclusions:

The incidence of rrPDAc has not changed despite advances in treatment.
Preventing SSIs and managing nodal status are key to reducing rrPDAc.
Adjuvant chemotherapy shows promise in lowering the risk of rapid recurrence, potentially improving survival outcomes.