Completion total pancreatectomy (CTP) for isolated PDAC recurrence

Pancreatic ductal adenocarcinoma (PDAC) is characterized by a poor prognosis and currently represents the fourth leading cause of cancer-related death. Outcomes of completion total pancreatectomy (CTP) for recurrent pancreatic ductal adenocarcinoma (PDAC) remain insufficiently defined. Therefore, it is of interest to evaluate perioperative safety and oncological outcomes in 84 patients undergoing CTP for isolated PDAC recurrence. Clinical variables including (R0) resection rate, operative parameters, morbidity, mortality and survival outcomes were analyzed. CTP achieved R0 resection in most cases with acceptable morbidity and mortality, while improved survival was associated with disease-free interval >24 months, CA 19-9 <37 U/mL and absence of lymph node metastasis. Thus, we show CTP as a viable salvage option providing meaningful long-term survival in selected patients with recurrent PDAC.