Risk of Recurrence after Surgical Resection for Adenocarcinoma Arising from Intraductal Papillary Mucinous Neoplasia (IPMN) with Patterns of Distribution and Treatment-Reference-Cited by-同舟云学术

Risk of Recurrence after Surgical Resection for Adenocarcinoma Arising from Intraductal Papillary Mucinous Neoplasia (IPMN) with Patterns of Distribution and Treatment

Published:2023-10-24 Issue: Volume: Page:
ISSN:0003-4932
Container-title:Annals of Surgery
language:en
Short-container-title:

Author:

Lucocq James¹,Hawkyard Jake²,Robertson Francis P.²,Haugk Beate²,Lye Jonathan²,Parkinson Daniel²,White Steve²,Mownah Omar³,Zen Yoh³,Menon Krishna³,Furukawa Takaaki⁴,Inoue Yosuke⁴,Hirose Yuki⁴,Sasahira Naoki⁴,Feretis Michael⁵,Balakrishnan Anita⁵,Zelga Piotr⁵,Ceresa Carlo⁶,Davidson Brian⁶,Pande Rupaly⁷,Dasari Bobby⁷,Tanno Lulu⁸,Karavias Dimitrios⁸,Helliwell Jack⁹,Young Alistair⁹,Nunes Quentin¹⁰,Urbonas Tomas¹¹,Silva Michael¹¹,Gordon-Weeks Alex¹¹,Barrie Jenifer¹²,Gomez Dhanny¹²,van Laarhoven Stijn¹³,Doyle Joseph¹⁴,Bhogal Ricky¹⁴,Harrison Ewen¹⁵,Roalso Marcus¹⁶¹⁷,Ciprani Debora¹⁸,Aroori Somaiah¹⁸,Ratnayake Bathiya¹⁹,Koea Jonathan¹⁹,Capurso Gabriele²⁰,Bellotti Ruben²¹,Stättner Stefan²¹,Alsaoudi Tareq²²,Bhardwaj Neil²²,Jeffery Fraser²³,Connor Saxon²³,Cameron Andrew²⁴,Jamieson Nigel²⁴,Sheen Amy²⁵,Mittal Anubhav²⁶,Samra Jas²⁶,Gill Anthony²⁵²⁶²⁷,Roberts Keith⁷,Soreide Kjetil¹⁶²⁸,Pandanaboyana Sanjay²²⁹

Affiliation:

1. Department of General Surgery, NHS Lothian, UK

2. Hepatopancreatobiliary and Transplant Unit, Freeman Hospital, Newcastle upon Tyne, UK

3. Institute of Liver Studies, King’s Healthcare Partners, King’s College Hospital NHS Foundation Trust, Denmark Hill, London SE5 9RS, UK

4. Cancer Institute Hospital of Japanese Foundation for Cancer Research, Hepato-Biliary-Pancreatic Medicine Department, Tokyo, Japan

5. Cambridge Hepatobiliary and Pancreatic Surgery Unit, Addenbrooke’s Hospital, Cambridge, UK

6. Hepatobiliary and Pancreatic Surgery Unit, The Royal Free Hospital, London, UK

7. Hepatobiliary and Pancreatic Surgery Unit, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham, UK

8. Hepatobiliary and Pancreatic Surgery Unit, University Hospital Southampton, Southampton, UK

9. Hepatobiliary and Pancreatic Surgery Unit, Leeds Teaching Hospitals NHS Trust, Leeds, UK

10. Department of Hepatopancreatobiliary Surgery, East Lancashire Teaching Hospitals NHS Trust, UK

11. Oxford Hepato-Pancreato-Biliary (HPB) surgical unit, Oxford University Hospitals NHS Foundation Trust, UK

12. Nottingham Hepato-Pancreatico-Biliary (HPB) Service, Nottingham University Hospitals NHS Foundation Trust, UK

13. Department of General Surgery, University Hospitals Bristol & Weston NHS Foundation trust, UK

14. Gastrointestinal Unit, The Royal Marsden NHS Foundation Trust, London, UK

15. Department of Clinical Surgery, University of Edinburgh, UK

16. Department of Gastrointestinal Surgery, HPB unit, Stavanger University Hospital, Norway

17. Department of Quality and Health Technology, University of Stavanger, Stavanger, Norway

18. Hepatopancreatobiliary Unit, University Hospitals Plymouth NHS Trust, Plymouth, UK

19. Hepato-pancreatico-biliary/Upper Gastrointestinal Unit, North Shore Hospital, Auckland, NZ

20. San Raffaele Scientific Institute, Vita Salute San Raffaele University, Milan, Italy; Digestive and Liver Disease Unit, S. Andrea Hospital, Rome, Italy

21. Department of Visceral, Transplant and Thoracic Surgery, Innsbruck Medical University, Austria

22. Leicester Hepatopancreatobiliary Unit, University Hospitals of Leicester NHS Trust, UK

23. Department of General and Vascular Surgery, Christchurch Hospital, New Zealand

24. Wolfson Wohl Cancer Research Centre, University of Glasgow, UK

25. New South Wales Health Pathology, Dept of Anatomical Pathology, Royal North Shore Hospital, Sydney, NSW, Australia

26. Royal North Shore Hospital, Sydney, NSW, Australia

27. Sydney Medical School, University of Sydney, Sydney NSW Australia

28. Department of Clinical Medicine, University of Bergen, Bergen, Norway

29. Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK

Abstract

Objective: This international multicentre cohort study aims to identify recurrence patterns and treatment of first and second recurrence in a large cohort of patients after pancreatic resection for adenocarcinoma arising from IPMN. Summary Background Data: Recurrence patterns and treatment of recurrence post resection of adenocarcinoma arising from IPMN are poorly explored. Method: Patients undergoing pancreatic resection for adenocarcinoma from IPMN between January 2010 to December 2020 at 18 pancreatic centres were identified. Survival analysis was performed by the Kaplan-Meier log rank test and multivariable logistic regression by Cox-Proportional Hazards modelling. Endpoints were recurrence (time-to, location, and pattern of recurrence) and survival (overall survival and adjusted for treatment provided). Results: Four hundred and fifty-nine patients were included (median, 70 y; IQR, 64-76; male, 54 percent) with a median follow-up of 26.3 months (IQR, 13.0-48.1 mo). Recurrence occurred in 209 patients (45.5 percent; median time to recurrence, 32.8 months, early recurrence [within 1 y], 23.2 percent). Eighty-three (18.1 percent) patients experienced a local regional recurrence and 164 (35.7 percent) patients experienced distant recurrence. Adjuvant chemotherapy was not associated with reduction in recurrence (HR 1.09;P=0.669) One hundred and twenty patients with recurrence received further treatment. The median survival with and without additional treatment was 27.0 and 14.6 months (P<0.001), with no significant difference between treatment modalities. There was no significant difference in survival between location of recurrence (P=0.401). Conclusion: Recurrence after pancreatic resection for adenocarcinoma arising from IPMN is frequent with a quarter of patients recurring within 12 months. Treatment of recurrence is associated with improved overall survival and should be considered.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Surgery

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