TY - JOUR
T1 - Feasibility of local therapy for recurrent pancreatic cancer
AU - Sato, Hiroki
AU - Yoshida, Ryuichi
AU - Yasui, Kazuya
AU - Umeda, Yuzo
AU - Yoshida, Kazuhiro
AU - Fuji, Tomokazu
AU - Kumano, Kenjiro
AU - Takagi, Kosei
AU - Yagi, Takahito
AU - Fujiwara, Toshiyoshi
N1 - Funding Information:
The authors have no conflicts of interests to disclose, and there was no financial support associated with this study to declare. We thank Kokichi Miyamoto, Department of Gastroenterological Surgery, Okayama University Hospital, for the collection of patient data.
Publisher Copyright:
© 2022 IAP and EPC
PY - 2022
Y1 - 2022
N2 - Background: Despite advances in perioperative management, recurrence after curative pancreatectomy is a critical issue in the treatment of pancreatic ductal adenocarcinoma (PDAC). The significance of local therapy for recurrent PDAC remains unclear. Methods: We reviewed the medical records of patients with PDAC who underwent curative resection at our institution between January 2009 and December 2019. We examined the patterns of relapse and assessed the clinical outcomes of patients with recurrence who underwent local therapy, including surgical resection, radiotherapy, and radiofrequency ablation. Results: A total of 246 patients with PDAC who underwent R0 or R1 resection were included in this study. The 3-year overall survival (OS) rate was 39.8%, and the 1-year recurrence-free survival rate was 51.2% for the entire population. Recurrence was observed in 172/246 (69.9%) patients, including multiple site recurrences in 50, liver metastasis in 41, locoregional recurrence in 34, and peritoneal dissemination in 27. Of the 172 patients, treatment was administered in 137 (79.7%), and 16 received local therapy, including surgical resection (n = 13), radiotherapy (n = 5), and RFA (n = 1). PS-matched analysis revealed that patients with recurrence who were treated with chemotherapy combined with local therapy showed better post-recurrence survival rates than those treated with chemotherapy alone (P = 0.016). Detailed clinical courses of these patients are presented in the main manuscript. Conclusions: Our results suggest that a multimodal approach may improve the clinical outcomes of patients with recurrent PDAC.
AB - Background: Despite advances in perioperative management, recurrence after curative pancreatectomy is a critical issue in the treatment of pancreatic ductal adenocarcinoma (PDAC). The significance of local therapy for recurrent PDAC remains unclear. Methods: We reviewed the medical records of patients with PDAC who underwent curative resection at our institution between January 2009 and December 2019. We examined the patterns of relapse and assessed the clinical outcomes of patients with recurrence who underwent local therapy, including surgical resection, radiotherapy, and radiofrequency ablation. Results: A total of 246 patients with PDAC who underwent R0 or R1 resection were included in this study. The 3-year overall survival (OS) rate was 39.8%, and the 1-year recurrence-free survival rate was 51.2% for the entire population. Recurrence was observed in 172/246 (69.9%) patients, including multiple site recurrences in 50, liver metastasis in 41, locoregional recurrence in 34, and peritoneal dissemination in 27. Of the 172 patients, treatment was administered in 137 (79.7%), and 16 received local therapy, including surgical resection (n = 13), radiotherapy (n = 5), and RFA (n = 1). PS-matched analysis revealed that patients with recurrence who were treated with chemotherapy combined with local therapy showed better post-recurrence survival rates than those treated with chemotherapy alone (P = 0.016). Detailed clinical courses of these patients are presented in the main manuscript. Conclusions: Our results suggest that a multimodal approach may improve the clinical outcomes of patients with recurrent PDAC.
KW - Local therapy
KW - Pancreatic ductal adenocarcinoma
KW - Recurrence
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U2 - 10.1016/j.pan.2022.05.004
DO - 10.1016/j.pan.2022.05.004
M3 - Article
C2 - 35641368
AN - SCOPUS:85131045557
JO - Pancreatology
JF - Pancreatology
SN - 1424-3903
ER -