Risk of Recurrence after Surgical Resection for Adenocarcinoma Arising from Intraductal Papillary Mucinous Neoplasia (IPMN) with Patterns of Distribution and Treatment: An International, Multicentre, Observational Study
Author
Lucocq, JamesHawkyard, Jake
Robertson, Francis P
Haugk, Beate
Lye, Jonathan
Parkinson, Daniel
White, Steve
Mownah, Omar
Zen, Yoh
Menon, Krishna
Furukawa, Takaaki
Inoue, Yosuke
Hirose, Yuki
Sasahira, Naoki
Feretis, Michael
Balakrishnan, Anita
Zelga, Piotr
Ceresa, Carlo
Davidson, Brian
Pande, Rupaly
Dasari, Bobby
Tanno, Lulu
Karavias, Dimitrios
Helliwell, Jack
Young, Alistair
Nunes, Quentin
Urbonas, Tomas
Silva, Michael
Gordon-Weeks, Alex
Barrie, Jenifer
Gomez, Dhanny
van Laarhoven, Stijn
Doyle, Joseph
Bhogal, Ricky
Harrison, Ewen
Roalso, Marcus
Ciprani, Debora
Aroori, Somaiah
Ratnayake, Bathiya
Koea, Jonathan
Capurso, Gabriele
Bellotti, Ruben
Stättner, Stefan
Alsaoudi, Tareq
Bhardwaj, Neil
Jeffery, Fraser
Connor, Saxon
Cameron, Andrew
Jamieson, Nigel
Sheen, Amy
Mittal, Anubhav
Samra, Jas
Gill, Anthony
Roberts, Keith
Soreide, Kjetil
Pandanaboyana, Sanjay
Publication date
2023-10-24
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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.Citation
Lucocq J, Hawkyard J, Robertson FP, Haugk B, Lye J, Parkinson D, White S, Mownah O, Zen Y, Menon K, Furukawa T, Inoue Y, Hirose Y, Sasahira N, Feretis M, Balakrishnan A, Zelga P, Ceresa C, Davidson B, Pande R, Dasari B, Tanno L, Karavias D, Helliwell J, Young A, Nunes Q, Urbonas T, Silva M, Gordon-Weeks A, Barrie J, Gomez D, van Laarhoven S, Doyle J, Bhogal R, Harrison E, Roalso M, Ciprani D, Aroori S, Ratnayake B, Koea J, Capurso G, Bellotti R, Stättner S, Alsaoudi T, Bhardwaj N, Jeffery F, Connor S, Cameron A, Jamieson N, Sheen A, Mittal A, Samra J, Gill A, Roberts K, Soreide K, Pandanaboyana S. Risk of Recurrence After Surgical Resection for Adenocarcinoma Arising From Intraductal Papillary Mucinous Neoplasia (IPMN) With Patterns of Distribution and Treatment: An International, Multicenter, Observational Study (ADENO-IPMN Study). Ann Surg. 2024 Jul 1;280(1):126-135. doi: 10.1097/SLA.0000000000006144. Epub 2023 Oct 24.Type
ArticleAdditional Links
https://journals.lww.com/annalsofsurgery/pages/default.aspxPMID
37873663Journal
Annals of SurgeryPublisher
Lippincott, Williams & Wilkinsae974a485f413a2113503eed53cd6c53
10.1097/SLA.0000000000006144