Completion pancreatectomy for recurrent pancreatic cancer in the remnant pancreas: report of six cases and a review of the literature

Shima, Yasuo; Okabayashi, Takehiro; Kozuki, Amane; Sumiyoshi, Tatsuaki; Tokumaru, Teppei; Saisaka, Yuichi; Date, Keiichi; Iwata, Jun

doi:10.1007/s00423-015-1355-2

Cited by 30 publications

(23 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…After screening titles and abstracts, 243 full-text articles were assessed for eligibility and 14 studies [1,6,15,16,17,18,19,20,21,22,23,24,25,26] were ultimately included in our critical appraisal (Figure 1). Nine papers dealt with isolated local recurrences (ILR) [1,16,17,18,19,20,21,22,26], two with the surgical treatment of lung metastases [24,25], and three reported the surgical results of both local and distant pancreatic recurrences [6,15,23]. Indications for re-resection/exploration in these patients were a strong probability of a potentially-resectable recurrence and no signs of further disseminated disease in patients in acceptable general conditions (ASA, American Society of Anesthesiologists, 1–3).…”

Section: Resultsmentioning

confidence: 99%

“…However, the real proportion of resected patient over the total number of recurrence, is considerably less. A subgroup analysis of the case series presenting both, the number of patients recurrent and resected [1,6,15,16,17,19,20,21,22,23,25], show a proportion of resection/recurrence rate of 6.4% (82 out of 1281 patients) (Table 1).…”

Section: Resultsmentioning

confidence: 99%

“…Six studies [15,18,20,21,23,27] also provided data on 244 patients with recurrences that were not treated surgically due to either locally unresectable disease or disseminated distant disease. In these patients the median overall survival (OS) ranged between 10.8 and 30 months after primary pancreatectomy, and between 6 and 11 months after their recurrent PDAC was diagnosed.…”

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Surgery for Recurrent Pancreatic Cancer: Is It Effective?

Moletta

Serafini

Valmasoni

et al. 2019

Cancers

View full text Add to dashboard Cite

Despite improvements to surgical procedures and novel combinations of drugs for adjuvant and neoadjuvant therapies for pancreatic adenocarcinoma, the recurrence rate after radical surgery is still high. Little is known about the role of surgery in the treatment of isolated recurrences of pancreatic cancer. The aim of this study was to review the current literature dealing with surgery for recurrent pancreatic cancer in order to examine its feasibility and effectiveness. An extensive literature review was conducted according to the 2009 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and 14 articles dealing with re-resections for recurrent pancreatic adenocarcinoma were analyzed, focusing on the characteristics of the primary neoplasm and its recurrence, the surgical procedures used, and patient outcomes. Data were retrieved on a total of 301 patients. The interval between surgery for primary pancreatic cancer and the detection of a recurrence ranged from 2 to 120 months. The recurrence was local or regional in 230 patients, and distant in 71. The median overall survival was 68.9 months (range 3–152) after resection of the primary tumor, and 26.0 months (range 0–112) after surgery for recurrent disease. The disease-free interval after the resection of recurrences was 14.2 months (range 4–29). Although data analysis was performed on a heterogeneous and limited number of patients, some of these may benefit from surgery for isolated recurrence of pancreatic adenocarcinoma. Further studies are needed to identify these cases.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Surgery for Recurrent Pancreatic Cancer: Is It Effective?

Moletta

Serafini

Valmasoni

et al. 2019

Cancers

View full text Add to dashboard Cite

show abstract

“…The detailed operative procedure for remnant pancreatic cancer has not been established. While complete pancreatectomy was performed in most of the patients who underwent repeated pancreatectomy in the former study [7,16], we preserved the pancreatic body at the second operation to maintain endocrine and exocrine functions of the pancreas and the quality of life of the patient. Therefore, we performed pancreas-preserving operation for the second tumor that was located in the distal portion of the pancreas tail, and the surgical margin was confirmed by intraoperative histopathologic examination of the frozen section.…”

Section: Discussionmentioning

confidence: 99%

Three Curative Pancreatectomies for the Metachronous Appearance of Pancreatic Invasive Ductal Adenocarcinoma

et al. 2020

View full text Add to dashboard Cite

We report a rare case of a patient who underwent 3 successful curative operations for the metachronous appearance of pancreatic cancer. In July 2007, a 54-year-old woman underwent pylorus-preserving pancreaticoduodenectomy. In March 2010, a tumor measuring 9 mm in diameter was detected in the tail of the pancreas on computed tomography (CT) and magnetic resonance imaging. The pancreas tail was subsequently resected while preserving the pancreatic body. In February 2011, CT revealed a cystic tumor measuring 2.5 cm in diameter in the remnant pancreatic body without any metastasis; therefore, total resection of the residual pancreas was performed in April 2011. The first resected tumor was histopathologically diagnosed as undifferentiated adenocarcinoma with osteoclast-like giant cells. Additionally, the third resected tumor had similar undifferentiated components. Contrarily, the second resected tumor was diagnosed as a well-differentiated tubular adenocarcinoma. We consider that the tumor from the third operation was an intra-pancreatic metastasis of the primary cancer and that the tumor from the second operation was the second primary cancer. The patient responded well with good control of surgical diabetes for 92 months since the last pancreatectomy. This case suggested that aggressive repeated resection for recurrent pancreatic invasive ductal adenocarcinoma is beneficial in limited cases.

show abstract

“…In some studies, adjuvant therapy was administered after the initial operation [23]. Others have offered adjuvant therapy after both -initial and re-operation [18,[24][25][26][27]. Neoadjuvant therapy prior to the re-operation was only applied in two studies [17,28].…”

Section: Discussionmentioning

confidence: 99%

Site of Relapse of the Ductal Adenocarcinoma of the Pancreas affects Survival after Multimodal Therapy

Safi

Lehwald

Rehders

et al. 2020

Preprint

View full text Add to dashboard Cite

Background The ductal adenocarcinoma of the pancreas (PDAC) remains one of the most lethal malignancies. To date, no guidelines exists for isolated resectable metachronous disease. It is still unclear, which patients may benefit from relapse surgery. The aim of our study was to compare disease free survival (DFS) and relapse specific survival (RSS) in patients with isolated local recurrence, metachronous hepatic or pulmonary metastases. Methods Patients with isolated resectable metachronous disease of either local recurrence, hepatic or pulmonary metastases were included for survival analyses. RSS of surgically treated patients (local (n = 11), hepatic (n = 6) and pulmonary metastases (n = 11)) were compared to conservative treated patients (local (n = 20), hepatic (n = 49) and pulmonary metastases (n = 14)). Results Patients with isolated metachronous hepatic metastases showed a higher T-stage and hepatic M-stage in the primary staging of the previous resected PDAC when compared to the other patients. DFS before diagnosed pulmonary metastases was longer compared to DFS before diagnosed hepatic metastases or local recurrence. Surgical resection only significantly improved RSS in patients with local recurrence or pulmonary metastases, when compared to patients after chemotherapy. Long-term survivors (> 5 years) were only detected after surgery for isolated local recurrence and 45% of these patients were still alive in our study. Conclusion Although DFS before diagnosed isolated local recurrence was dismal and comparable to patients with isolated hepatic metastases, long-term survivors were only detected in this group, recommending a surgical approach if resectability is provided.

show abstract

Completion pancreatectomy for recurrent pancreatic cancer in the remnant pancreas: report of six cases and a review of the literature

Cited by 30 publications

References 21 publications

Surgery for Recurrent Pancreatic Cancer: Is It Effective?

Surgery for Recurrent Pancreatic Cancer: Is It Effective?

Three Curative Pancreatectomies for the Metachronous Appearance of Pancreatic Invasive Ductal Adenocarcinoma

Site of Relapse of the Ductal Adenocarcinoma of the Pancreas affects Survival after Multimodal Therapy

Contact Info

Product

Resources

About