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Patterns, timing and predictors of recurrence following pancreaticoduodenectomy for pancreatic ductal adenocarcinoma: an international multicentre retrospective cohort study

Labib, Peter L Z
; 
Russell, Thomas B
; 
Denson, Jemimah L
; 
Puckett, Mark A
; 
Ausania, Fabio
; 
Pando, Elizabeth
; 
Roberts, Keith J
; 
Kausar, Ambareen
; 
Mavroeidis, Vasileios K
; 
Bhogal, Ricky H
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Affiliation
University Hospitals Plymouth NHS Trust; Hospital Clínic de Barcelona; Hospital Universitari Vall d'Hebron; University Hospitals Birmingham NHS Foundation Trust; East Lancashire Hospital NHS Trust; University Hospitals Bristol and Weston NHS Foundation Trust; Royal Marsden NHS Foundation Trust; University Hospitals Coventry and Warwickshire NHS Trust; NHS Lothian; Royal Surrey NHS Foundation Trust; Imperial College Healthcare NHS Trust; Hull University Teaching Hospitals NHS Trust; Medical University of Innsbruck; Ibn Sina Specialist Hospital; King's College Hospital NHS Foundation Trust; Shaukat Khanum Memorial Cancer Hospital; Leeds Teaching Hospitals NHS Trust; Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán; Monash Medical Centre; Newcastle upon Tyne Hospitals NHS Foundation Trust; Nottingham University Hospitals NHS Trust; Oxford University Hospitals NHS Foundation Trust; Policlinico Umberto I Sapienza University of Rome; Royal Free London NHS Foundation Trust; Azienda Ospedaliero Universitaria di Sassari; Sheffield Teaching Hospitals NHS Foundation Trust; University Hospital Southampton Foundation Trust; Swansea Bay University Health Board; Hospital Universitario Miguel Servet
Other Contributors
Browning, Matthew
Mownah, Omar
Gonzalez-Abos, Carolina
Fernandes, Nair
Moller, Elsa G
Taboada, Cristina D
Pande, Rupaly
Alfarah, Jameel
Bandyopadhyay, Samik
Abdelrahim, Ahmed
Khan, Ayesha
Jordan, Caitlin
Rees, Jonathan R E
Doyle, Joseph
Bledge, Harry
Cambridge, William
White, Olga
Blacker, Sarah
Blackburn, Jessie
Sweeney, Casie
Fehervari, Matyas
Oai, Madhava
Alghazawi, Laith
Onifade, Anjola
Field, Daniel
Gouda, Mohammed
Bellotti, Ruben
Hamid, Hytham K S
Ribaud, Juliette
Nair, Ashitha
Mariathasan, Michael
Grayson, Niamh
Ahmed, Hassan
Moriarty, Catherine
White, Louise
Priestley, Mark
Bode, Kerry
Sharp , Judith
Wragg, Rosie
Jackson, Beverley
Craven, Samuel
Guerrero, Alan
Moguel, Andre
Chan, Carlos
Jones, Michael
Buckley, Edward
Akter, Nasreen
Treherne, Kyle
Gordon, Gregory
Hughes, Daniel
Urbonas, Tomas
Brachini, Gioia
Caronna, Roberto
Chirletti, Piero
Pericleous, Stephanos
Patel, Krishna
Shaw, Conrad
Morare, Nolitha
Zaban, Mohamad K
Perra, Teresa
Abd Kahar, Nurul N
Hall, Thomas
Nadeem, Nabeegh
karar, Shoura
Arshad, Ali
Yarwood, Adam
Hammoda, Mohammed
Artigas, Maria C
Paterna-Lopez, Sandra
Publication date
2024-12-09
Subject
Gastroenterology
 Surgery
Collections
UHB Gastroenterology
Hepato-Pancreato-Biliary
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Abstract
Background: Most patients undergoing pancreaticoduodenectomy (PD) for pancreatic ductal adenocarcinoma (PDAC) develop recurrence. No previous studies have investigated predictors of local-only recurrence following PD for PDAC. Our study aimed to determine timing, pattern and predictors of any-site and local-only recurrence following PD for PDAC. Methods: Patients who underwent PD for PDAC between June 2012 and May 2015 (29 centres, eight countries) were included. The primary outcome was recurrence pattern (none, local-only, distant-only or mixed local/distant). Data were collected on demographics, comorbidities, investigations, operation details, complications, histology, adjuvant therapies, recurrence and survival. Univariable tests and regression analysis investigated factors associated with any-site and local-only recurrence. Results: Of 866 patients, 573 (66 %) developed recurrence: 170 (20 %) developed local-only recurrence, 164 (19 %) developed mixed local/distant recurrence, and 239 (28 %) developed distant-only recurrence. Local-only or lung-only recurrence had a more favourable prognosis than other recurrence patterns. Predictors of any-site recurrence were preoperative biliary stenting, venous resection and poorly-differentiated, node-positive tumours. Predictors of local-only recurrence were preoperative radiological lymphadenopathy, well-differentiated tumours, fewer than 15 resected lymph nodes and intraoperative blood transfusion. Discussion: Ensuring radical resection and avoiding intraoperative blood transfusion may reduce the risk of local-only recurrence following PD for PDAC.
Citation
Labib PLZ, Russell TB, Denson JL, Puckett MA, Ausania F, Pando E, Roberts KJ, Kausar A, Mavroeidis VK, Bhogal RH, Marangoni G, Thomasset SC, Frampton AE, Spalding DR, Lykoudis P, Maglione M, Alhaboob N, Srinivasan P, Bari H, Smith A, Dominguez-Rosado I, Croagh D, Thakkar RG, Gomez D, Silva MA, Lapolla P, Mingoli A, Davidson BR, Porcu A, Shah NS, Hamady ZZ, Al-Sarireh BA, Serrablo A, Aroori S; RAW study collaborators. Patterns, timing and predictors of recurrence following pancreaticoduodenectomy for pancreatic ductal adenocarcinoma: an international multicentre retrospective cohort study. HPB (Oxford). 2025 Apr;27(4):445-460. doi: 10.1016/j.hpb.2024.11.015. Epub 2024 Dec 9
Type
Article
Description
Handle
https://westmid.openrepository.com/handle/20.500.14200/8292
Additional Links
https://www.sciencedirect.com/journal/hpb
DOI
10.1016/j.hpb.2024.11.015
PMID
39870557
Journal
HPB
Publisher
Elsevier
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