795 Predictors and Timing of Recurrence After Surgical Resection of Pancreatic Adenocarcinoma

Aim

To investigate the predictors and timing of recurrence after curative resection for pancreatic adenocarcinoma (PDAC).

Method

Consecutive patients who underwent curative resection for PDAC (2011-21) and consented to data and tissue collection, were followed up prospectively in a single institution. Clinico-pathological variables were analysed using the Cox proportional hazards model.

Results

91 patients (median age 71 years (range 43 – 86)) had a median follow-up of 51 (95% CI 40–61) months. 66 (72.5%) patients experienced recurrence (12 locoregional, 11 liver, 5 lung, 3 peritoneal, 29 simultaneous locoregional and distant and 6 multi-focal distant). Median time to recurrence was 8.5 (95% CI 6.6-10.5) months and median survival after recurrence was 5.8 (95% CI 4.2-7.3) months.

Stratification by recurrence location revealed no significant differences in time to recurrence (p = 0.24). Significant predictors for any recurrence were lymph node ratio ≥0.33 (p = 0.005, HR 2.8, 95% CI 1.4 – 5.8), adjuvant chemotherapy (p = 0.002, HR 0.4, 95% CI 0.2 – 0.7) and systemic inflammation score ≥500 (p = 0.01, HR 4.5, 95% CI 1.4 – 14.3).

Conclusions

Lymph node ratio, adjuvant chemotherapy and systemic inflammation score were significant predictors for recurrence after curative resection for PDAC: this needs validation in large national cohorts.