Patterns of disease relapse and posttreatment follow‐up of patients with resected pancreatic adenocarcinoma: A single‐center analysis

Abstract

Background and Objectives To describe the patterns of disease relapse and follow‐up of patients with resected pancreatic adenocarcinoma. Additionally, we looked at patients' characteristics at relapse and survival. Methods We included patients with potentially resectable pancreatic adenocarcinoma diagnosed from 2008 to 2018 who were submitted to resection with clear macroscopic margins and started posttreatment surveillance. Results The study population consists of 73 patients. The median interval between imaging studies was 3.2 months during the first 2 years of follow‐up and 5.1 months thereafter. Forty‐eight patients (65.8%) experienced disease relapse. The most frequent single site of relapse was locoregional (N = 21; 43.8%). At relapse, 31 patients (64.6%) were symptomatic and forty‐two patients (87.6%) had Eastern Cooperative Oncology Group performance status 0 or 1. Most patients were able to undergo additional anticancer therapy (N = 41; 85.4%). Patients with asymptomatic relapses experienced longer median postrelapse survival (25.4 vs. 11.3 months; p = 0.015). Conclusions A follow‐up protocol that included imaging studies every 3 months in the first 2 years and every 6 months thereafter is able to diagnose disease relapse when patients have adequate performance status and are still able to undergo additional anticancer treatment.

Current Treatment of Potentially Resectable Pancreatic Ductal Adenocarcinoma: A Medical Oncologist’s Perspective

“…However, a structured follow-up protocol has many advantages, including nutritional and metabolic surveillance, psychological reassurance, and early initiation of systemic therapy in case of disease relapse. 181 In fact, retrospective data suggest an intense follow-up schedule allows patients to have their disease relapse diagnosed when they are asymptomatic or while they have adequate performance status, and to receive standard-of-care therapies. 181 After surgery, patients should undergo CT scans and have blood drawn for CA 19-9 levels.…”

“… 181 In fact, retrospective data suggest an intense follow-up schedule allows patients to have their disease relapse diagnosed when they are asymptomatic or while they have adequate performance status, and to receive standard-of-care therapies. 181 After surgery, patients should undergo CT scans and have blood drawn for CA 19-9 levels. These studies should be repeated every 3 months during the first 2 years and every 6 months thereafter up to 5 years after treatment completion.…”

Artificial intelligence in pancreatic surgery: current applications

“…Thus, in most studies, surveillance consists of clinical, laboratory (CA 19-9) and imaging follow-up every 3 to 6 months for 2 years after surgery, with subsequently extended intervals, mostly up to 6 months. [83–85]…”

“…Thus, in most studies, surveillance consists of clinical, laboratory (CA 19-9) and imaging follow-up every 3 to 6 months for 2 years after surgery, with subsequently extended intervals, mostly up to 6 months. [83][84][85] The use of AI could help to combine the vast amount of healthcare data from multiple centers to minimize limitations from smaller and single-center analyses. This could help develop more accurate risk models to improve the effectiveness of screening and surveillance programs, enhancing earlier detection of recurrence and avoiding overtreatment.…”