Clinical Outcome of Resected Remnant Pancreatic Cancer After Resection of the Primary Pancreatic Cancer

J Invest Surg. 2019 Nov;32(7):670-678. doi: 10.1080/08941939.2018.1452995. Epub 2018 Mar 28.

Abstract

Purpose: Pancreatic cancer (PC) has high morbidity and mortality rates, with a poor prognosis and frequent recurrence. The postresection survival rate has increased but remains low, and remnant PC is becoming more common. This review evaluates the current literature pertaining to the clinical outcomes of patients with resected remnant PC. Material and Methods: We reviewed publications on remnant PC that included repeated and completion pancreatectomy. Clinicophysiological data were analyzed, and survival rates were calculated using the Kaplan-Meier method. Remnant PC was defined by negative margins at the initial operation, a cancer-free interval >1 year, and presence in the remnant pancreas. Results: Forty-nine cases of remnant PC selected from the literature were examined. Primary and remnant PCs had the same histopathological features in 29 of 45 patients (64.4%). The median disease-free interval was 44.3 months (12-143 months). The 1- and 3-year survival rates after repeat pancreatectomy were 81.5% and 50%, respectively, and the median survival time was 32 months. The age of the patient at the time of the first operation independently predicted survival in a multivariate analysis. Conclusion: In long-term survivors after curative resection for PC, resectable remnant PCs should be aggressively removed to improve prognosis.

Keywords: initial pancreatic cancer; morbidity; remnant pancreatic cancer; total pancreatectomy.

Publication types

  • Review

MeSH terms

  • Disease-Free Survival
  • Humans
  • Kaplan-Meier Estimate
  • Neoplasm, Residual
  • Pancreatectomy / adverse effects*
  • Pancreatic Neoplasms / mortality
  • Pancreatic Neoplasms / surgery*
  • Prognosis
  • Survival Rate