Retrospective study about seven cases of total remnant pancreatectomy for remnant pancreatic cancer

Abstract

Introduction: There are few reports about the cases of remnant pancreatic cancer after surgery for pancreatic malignancy. However, in recent years, opportunities for total remnant pancreatectomy have increased with the progress of surgery, perioperative management and chemotherapy. We investigated the cases of remnant pancreatectomy in our institute. Methods: 292 patients underwent pancreatectomy for pancreatic malignancy from May 2007 to December 2019 in our institute. There were seven patients who underwent remnant pancreatectomy for remnant pancreatic cancer. These seven cases were retrospectively analyzed. Results: The depth of invasion was T1 in 1 case, T3 in 6 cases. Lymph node metastasis was observed in 3 cases. The stage was ⅠA in 1 case, ⅡA in 3 cases and ⅡB in 3 cases. Total remnant pancreatectomy was performed after distal pancreatectomy in 2 cases, and after pancreaticoduodenectomy in 5 cases. Three cases were histologically proven as recurrent pancreatic cancer. On the other hand, four cases had different histological findings. Therefore, these four cases were considered as metachronous pancreatic cancer. The mean disease free survival of recurrent group and metachronous group were 31 months and 62.5 months, respectively. Mean survival time after the first operation of recurrent group and metachronous group were 57 months and 84 months. No significant difference was observed, but it was longer in metachronous cases. Both recurrent and metachronous groups had one case who survived over 3 years each. Conclusion: Cases of metachronous pancreatic cancer had a longer time to recurrence. Some cases may obtaine long term survival by total remnant pancreatectomy.