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Observational Study
. 2024 Jul 1;280(1):126-135.
doi: 10.1097/SLA.0000000000006144. Epub 2023 Oct 24.

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)

James Lucocq  1 , Jake Hawkyard  2 , Francis P Robertson  2 , Beate Haugk  2 , Jonathan Lye  2 , Daniel Parkinson  2 , Steve White  2 , Omar Mownah  3 , Yoh Zen  3 , Krishna Menon  3 , Takaaki Furukawa  4 , Yosuke Inoue  4 , Yuki Hirose  4 , Naoki Sasahira  4 , Michael Feretis  5 , Anita Balakrishnan  5 , Piotr Zelga  5 , Carlo Ceresa  6 , Brian Davidson  6 , Rupaly Pande  7 , Bobby Dasari  7 , Lulu Tanno  8 , Dimitrios Karavias  8 , Jack Helliwell  9 , Alistair Young  9 , Quentin Nunes  10 , Tomas Urbonas  11 , Michael Silva  11 , Alex Gordon-Weeks  11 , Jenifer Barrie  12 , Dhanny Gomez  12 , Stijn van Laarhoven  13 , Joseph Doyle  14 , Ricky Bhogal  14 , Ewen Harrison  15 , Marcus Roalso  16   17 , Debora Ciprani  18 , Somaiah Aroori  18 , Bathiya Ratnayake  19 , Jonathan Koea  19 , Gabriele Capurso  20   21 , Ruben Bellotti  22 , Stefan Stättner  22 , Tareq Alsaoudi  23 , Neil Bhardwaj  23 , Fraser Jeffery  24 , Saxon Connor  24 , Andrew Cameron  25 , Nigel Jamieson  25 , Amy Sheen  26 , Anubhav Mittal  27 , Jas Samra  27 , Anthony Gill  26   27   28 , Keith Roberts  7 , Kjetil Soreide  16   29 , Sanjay Pandanaboyana  2   30
Affiliations
Observational Study

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)

James Lucocq et al. Ann Surg. .

Abstract

Objective: This international multicenter 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 intraductal papillary mucinous neoplasm (IPMN).

Background: Recurrence patterns and treatment of recurrence postresection of adenocarcinoma arising from IPMN are poorly explored.

Methods: Patients undergoing pancreatic resection for adenocarcinoma from IPMN between January 2010 and December 2020 at 18 pancreatic centers were identified. Survival analysis was performed using the Kaplan-Meier log-rank test and multivariable logistic regression by Cox-Proportional Hazards modeling. End points were recurrence (time-to, location, and pattern of recurrence) and survival (overall survival and adjusted for treatment provided).

Results: Four hundred fifty-nine patients were included (median, 70 years; interquartile range, 64-76; male, 54%) with a median follow-up of 78.1 months. Recurrence occurred in 209 patients [45.5%; median time to recurrence, 12.8 months; early recurrence (within 1 years), 23.2%]. Eighty-three (18.1%) patients experienced a local regional recurrence, and 164 (35.7%) patients experienced a distant recurrence. Adjuvant chemotherapy was not associated with reduction in recurrence (hazard ratio 1.09; P =0.669) One hundred 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 locations of recurrence ( P =0.401).

Conclusions: 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.

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Conflict of interest statement

The authors report no conflicts of interest.

Comment in

References

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