Is remnant pancreatic cancer after pancreatic resection more frequent in early‐stage pancreatic cancer than in advanced‐stage cancer?

Abstract

Aim As the prognosis of patients who undergo resection for pancreatic cancer has improved, reports of remnant pancreatic cancer after pancreatic cancer resection have been increasing. Previous studies regarding early‐stage pancreatic cancer showed a high incidence of remnant pancreatic cancer in these patients. The aim of this study was to investigate the incidence of remnant pancreatic cancer according to the degree of progression of the initial pancreatic cancer. Methods Patients who underwent partial pancreatic resection for primary pancreatic cancer were retrospectively reviewed and divided into an early‐stage group and an advanced‐stage group according to the stage of the initial cancer. Patient characteristics and long‐term outcomes, including development of remnant pancreatic cancer, were compared between the two groups. Results This study included 321 patients who underwent partial pancreatectomy for pancreatic cancer; 32 patients in the early‐stage group and 289 patients in the advanced‐stage group. Remnant pancreatic cancer developed in 19 patients (5.9%); seven patients (21.9%) in the early‐stage group and 12 patients (4.5%) in the advanced‐stage group. The cumulative incidence of remnant pancreatic cancer according to the Kaplan–Meier method was comparable between the two groups (5‐year cumulative incidence: 20.6% vs 9.9%, early‐stage group vs advanced‐stage group; P = .1827). Conclusion Our results suggested that the potential for developing remnant pancreatic cancer was comparable between the early‐stage and the advanced‐stage groups. Therefore, the incidence of remnant pancreatic cancer may increase along with improved pancreatic cancer treatment.

Outcomes of remnant pancreatic resection for recurrent pancreatic cancer

“…The feasibility and usefulness of remnant pancreatic resection has been reported in several retrospective studies [3,4,[10][11][12], and our results were consistent with these reports. Our data showed that remnant pancreatic resection was more frequent in early-stage pancreatic cancer.…”

“…Ikemoto et al [13] and Kanno et al [14] reported that patients with early-stage pancreatic cancer (stage 0-I) showed a high incidence of remnant pancreatic cancer. However, Miyasaka et al [10] reported that the potential for developing remnant pancreatic cancer was comparable between early-stage and the advanced-stage groups. Yamada et al [4] also reported that the short distance from the pancreatic stump (less than 10 mm) could be a prognostic factor for local recurrence after pancreatic resection.…”

Clinical application of pancreatic juice‐derived small extracellular vesicles of pancreatic ductal adenocarcinoma

“…Miyasaka et al reported that remnant pancreatic cancer developed more frequently after the resection of cancer in the pancreatic body-tail. 53 Makohon-Moore et al revealed that precancerous neoplastic cells, such as PanINs, can move through the pancreatic ductal system and progress into PDAC with the accumulation of genetic and epigenetic changes. 54 Furthermore, initial PDACderived sEVs, which flow through the pancreatic duct from the body-tail to the head, could initiate the development of remnant PDAC through cell-to-cell communication.…”

“…Miyasaka et al. reported that remnant pancreatic cancer developed more frequently after the resection of cancer in the pancreatic body‐tail 53 . Makohon–Moore et al.…”

Curative remnant total pancreatectomy for recurrent pancreatic acinar cell carcinoma: A case report

“…Surgery remains the main curative treatment for pancreatic cancer, and sometimes, repeat resection is needed for recurrence. Recently, total pancreatectomy including remnant pancreatic resection has been aggressively performed [3] , [4] . Improvement with surgery and powerful combination chemotherapy often dramatically decreases the extension of pancreatic tumours [5] .…”