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Abstract Introduction Recurrence patterns and treatment of recurrence post resection of invasive IPMN are poorly explored. This 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 invasive IPMN. Method Patients undergoing pancreatic resection for invasive 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). Results Four hundred and fifty-nine patients were included (median, 70years; IQR, 64-76; male, 54 percent) with a median follow-up of 26.3 months (IQR, 13.0-48.1 months). Recurrence occurred in 209 patients (45.5 percent; median time to recurrence, 32.8 months, early recurrence within 1year, 20.2 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 (p0.001), with no significant difference between treatment modalities. There was no significant difference in survival between location of recurrence (p=0.401). Conclusion Recurrence after pancreatic resection for invasive 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.
James Lucocq (Fri,) studied this question.