Yusuke Watanabe, Kazuyoshi Nishihara, Yusuke Niina, Yuzan Kudo, Kanako Kurata, Takafumi Okayama, Atsushi Fujii, Shinichi Wakamatsu, Yuji Abe, Toru Nakano
Purpose To investigate recent recurrence patterns after curative resection for pancreatic ductal adenocarcinoma and the association between the recurrence pattern and prognosis. Methods We retrospectively reviewed the medical records of 129 patients who underwent curative resection for pancreatic ductal adenocarcinoma. Results Of the 129 patients, 90 developed recurrence. Recurrence occurred in the liver in 45 patients (50%), lung in 11 (12%), peritoneum in 34 (38%), and local tissue in 26 (29%). The number of patients with lung recurrence was significantly higher in the second half of the study period (10/57, 18%) than in the first half (1/33, 3%; P=0.04). Adjuvant chemotherapy was more frequently performed in patients with lung recurrence (9/11, 82%) than in those with recurrence at other sites (40/79, 51%; P=0.04). Patients with lung recurrence only (n=8) had a significantly better prognosis than those with other patterns of recurrence (n=82) in terms of recurrence-free survival (P=0.02), time from recurrence to death (P=0.02), and overall survival (P<0.01). Multivariate analysis showed that lung recurrence was an independent favorable factor for the time from recurrence to death (HR: 0.09; 95% CI: 0.02–0.35) and overall survival (HR: 0.12; 95% CI: 0.03–0.40). Conclusions The incidence of lung recurrence after pancreatectomy for pancreatic ductal adenocarcinoma has recently increased, which may be due to the recent establishment of adjuvant chemotherapy. Patients with lung recurrence have a better prognosis than those with recurrence at other sites.
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