• James Lucocq, Jake Hawkyard, Francis P Robertson, Beate Haugk, Jonathan Lye, Daniel Parkinson, Steve White, Omar Mownah, Yoh Zen, Krishna Menon, Takaaki Furukawa, Yosuke Inoue, Yuki Hirose, Naoki Sasahira, Michael Feretis, Anita Balakrishnan, Piotr Zelga, Carlo Ceresa, Brian Davidson, Rupaly Pande, Bobby Dasari, Lulu Tanno, Dimitrios Karavias, Jack Helliwell, Alistair Young, Quentin Nunes, Tomas Urbonas, Michael Silva, Alex Gordon-Weeks, Jenifer Barrie, Dhanny Gomez, Stijn van Laarhoven, Joseph Doyle, Ricky Bhogal, Ewen Harrison, Marcus Roalso, Debora Ciprani, Somaiah Aroori, Bathiya Ratnayake, Jonathan Koea, Gabriele Capurso, Ruben Bellotti, Stefan Stättner, Tareq Alsaoudi, Neil Bhardwaj, Fraser Jeffery, Saxon Connor, Andrew Cameron, Nigel Jamieson, Amy Sheen, Anubhav Mittal, Jas Samra, Anthony Gill, Keith Roberts, Kjetil Soreide, and Sanjay Pandanaboyana.
• Department of General Surgery, NHS Lothian, UK.
• Ann. Surg. 2023 Oct 24.

ObjectiveThis international multicentre 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 IPMN.Summary Background DataRecurrence patterns and treatment of recurrence post resection of adenocarcinoma arising from IPMN are poorly explored.MethodPatients undergoing pancreatic resection for adenocarcinoma from IPMN between January 2010 to December 2020 at 18 pancreatic centres were identified. Survival analysis was performed by the Kaplan-Meier log rank test and multivariable logistic regression by Cox-Proportional Hazards modelling. Endpoints were recurrence (time-to, location, and pattern of recurrence) and survival (overall survival and adjusted for treatment provided).ResultsFour hundred and fifty-nine patients were included (median, 70 y; IQR, 64-76; male, 54 percent) with a median follow-up of 26.3 months (IQR, 13.0-48.1 mo). Recurrence occurred in 209 patients (45.5 percent; median time to recurrence, 32.8 months, early recurrence [within 1 y], 23.2 percent). Eighty-three (18.1 percent) patients experienced a local regional recurrence and 164 (35.7 percent) patients experienced distant recurrence. Adjuvant chemotherapy was not associated with reduction in recurrence (HR 1.09;P=0.669) One hundred and 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 location of recurrence (P=0.401).ConclusionRecurrence 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.Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.

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