Factors associated with early recurrence after curative resection for panrceatic cancer.

Abstract

Introduction: Adjuvant chemotherapy is recommended after curative resection of pancreatic cancer. But early recurrence before the end time of the chemotherapy is sometimes observed, which exhibited poor prognosis. We sought to find the factors which affect the early relapse of pancreatic cancer. Method: We searched curatively resected cases of pancreatic adenocarcinoma among 2006-2014 in our faculty retrospectively. We defined early recurrence as relapse within 6 months after surgery, and patients were classified into early recurrence (group A), late recurrence (group B) and no recurrence group(group C). Result: A total of 86 patients were identified and 55 cases were eligible, 10 in group A, 31 in group B and 14 in group C. Clinical characteristics among the groups was not significant except the profile of lymph node metastasis. Postoperative complication (worse than Clavien-Dindo grade 2) and later initiation of adjuvant chemotherapy (more than 30 days after the surgery) were significantly corelated to group A when compared with group B. Cox regression analysis showed significant association The lymph node metastasis (N1a:HR 0.183 [95% CI 0.076-0.438]; P < 0.01, N1b: HR 0.325 [95% CI 0.137-0.773]; P = 0.011) and the initiation date of adjuvant chemotherapy (HR 10.146 [95% CI 2.066-49.825]; P < 0.01) were also associated with disease-free survival. Conclusion: We detected the lymph node metastasis and delay of adjuvant chemotherapy as possible factors which support to predict early recurrence of pancreatic cancer. However, additional study with extended number and follow-up are needed to validate our findings.