Factors Associated With Early Recurrence in Ductal Adenocarcinoma of the Pancreas

Abstract BACKGROUND Pancreatic ductal adenocarcinoma presents a significant challenge due to its often late-stage diagnosis, with only 15–20% of patients eligible for surgical intervention. Surgical resection, combined with advanced oncological therapies, has shown promise in improving patient survival. Understanding factors influencing early recurrence post-surgery is crucial for prognosis evaluation. METHODS This retrospective study, spanning from January 2010 to January 2020, focused on patients undergoing surgery for pancreatic cancer at a single center. Criteria for inclusion involved patients over 18 years with anatomopathological diagnoses of pancreatic adenocarcinoma or undifferentiated carcinoma, devoid of metastasis at the time of surgery, and possessing complete recurrence data during follow-up. Early recurrence, defined as relapse within a year, was assessed alongside overall and disease-free survival, measured from the date of pancreatic tumor resection surgery to death or relapse. Survival analysis utilized the Kaplan-Meier method. Statistical comparisons employed Chi-square, Wilcoxon, or Student tests as appropriate, facilitated by R software. RESULTS A total of 176 patients with post-surgical recurrence of pancreatic cancer were included. The group with early recurrences was made up of 79 patients, while the rest were included in the group of late recurrences. No differences were found in age, sex, survival, type of surgical resection, need for venous resection, type of adenocarcinoma (ductal vs undifferentiated), tumor size, number of nodes resected, number of positive nodes, perineural and perivascular infiltration. Significant differences were found in pre- and postoperative CA 19 − 9 values ​​and in adjuvant treatment (complete, incomplete, and null). CONCLUSIONS The level of CA 19 − 9 preoperative and postoperative are associated with early recurrence. Complete adjuvant treatment was associated with late recurrence. There were no statistically significant differences in the rest of the variables analyzed.