Treatment outcomes for stage 1 pancreatic cancer

Abstract

Introduction: Pancreatic cancer still has a poor prognosis. Post-resection recurrence is still a problem. To examine the patterns of recurrence and its treatment among stage 1 pancreatic cancer patients in our hospital. Method: From among 199 pancreatic cancer (including IPMC) patients who underwent resection between January 2010 and December 2018, 27 patients (13.5%) with stage 1. Result: Preoperative chemotherapy had been performed on 1 patient (3.7%). The surgical procedure was PD for 13 patients, DP for 9 patients, and TP for 5 patients. Pathology findings were T1 for 18 patients, T2 for 9 patients, ly1≤ for 6 patients, v1≤ for 11 patients, ne1≤ for 8 patients, mpd1 for 14 patients , and the (median) number of lymph nodes dissected was 15. 4 patients (14.8%) underwent chemotherapy postoperatively. The 5-year survival rate was 63.6%. Recurrence was seen in 4 patients (14.8%), the (median) length of time until recurrence was 16 months, and the site of recurrence was the remnant pancreas in 3 patients and the lung in 1 patient. In contrast, recurrence was seen in 80 patients (46.5%) at stage 2≤, and the site of recurrence was the liver in 33 patients, peritoneal in 22 patients, local recurrence in 18 patients, the lung in 14 patients, and the remnant pancreas in 7 patients (some patients had multiple recurrence sites). Patients with recurrence to the remnant pancreas, all underwent radical resection of the remnant pancreas. The (median) length of postoperative monitoring was 19 months, and a second recurrence was not seen in any of these cases. Conclusion: Postoperative recurrence of pancreatic cancer is a problem even in stage 1 cancer. This study found that postoperative recurrence occurs often in the remnant pancreas, but radical resection can be performed, and an improved prognosis may be expected.