Predictors of Early Recurrence of Adenocarcinoma of the Head of the Pancreas after Curative Resection

Objective To determine the time to recurrence of pancreatic adenocarcinoma of the head of the pancreas after curative resection at one tertiary-care Health Care Campus and to determine the factors that predict early recurrence. Methods Retrospective data was gathered from 64 consecutive pancreatic adenocarcinoma patients undergoing curative Whipple procedures from 2007-2011. Patients were divided into early recurrence, within 185 days, and late or no recurrence. Results Disease-free survival after 6 months was 64%; at 8 months, it was 50%. Factors that contributed to early recurrence included increased age at surgery (P=0.03746), larger tumor size on pathology (P=0.0093), and resection margins less than 0.1mm (P=0.0471). Larger tumor size as measured by endoscopic ultrasound showed a trend for early recurrence (P=0.086821). Conclusions Aggressive screening and detection mechanisms for pancreatic carcinoma should be applied more frequently and with increased age to ensure identification of pancreatic carcinoma before large growth in tumor size.

Author(s): Eugene Pahk, Raphael Jesin, Yoram Kluger, Ron Epelbaum, Jesse Lachter

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