Pancreatic cancer arising from the remnant pancreas after pancreatectomy

a multicenter retrospective study by the Kyushu Study Group of Clinical Cancer

Daisuke Hashimoto, Kota Arima, Shigeki Nakagawa, Yuji Negoro, Toshihiko Hirata, Masahiko Hirota, Masafumi Inomata, Kengo Fukuzawa, Takefumi Ohga, Hiroshi Saeki, Eiji Oki, Yo ichi Yamashita, Akira Chikamoto, Hideo Baba, Yoshihiko Maehara

Research output: Contribution to journalArticle

Abstract

Background: After initial pancreatic resection, local recurrence of pancreatic cancer (PC) or new primary PC can develop in the remnant. There are limited data available regarding this so-called remnant PC. The aim of this retrospective study was to clarify the clinical features and establish a treatment strategy for remnant PC. Methods: A multicenter retrospective study with the Kyushu Study Group of Clinical Cancer was carried out. Clinical data from 50 patients who developed remnant PC were analyzed. RAS mutation analysis of the initial tumor and of remnant PC was performed in 17 cases. Results: The initial pancreatic resections were performed for 37 invasive ductal carcinomas, and for 13 other tumors. Thirty-seven patients underwent a second pancreatectomy for remnant PC (resected group), while thirteen patients were not operated (unresected group). The median overall survival times were 42.2 months in the resected group and 12.3 months in the unresected group (HR 0.374; 95% CI 0.17–0.83). In RAS mutation analysis, 14 cases had at least 1 missense variant of KRAS, HRAS, or NRAS in the initial pancreatic tumor and/or remnant PC. The same missense variants between the initial tumor and remnant PC were discovered only in KRAS of one patient, and in HRAS of one patient. No case had completely consistent missense variants between the initial tumor and remnant PC. Conclusions: This study found that repeated pancreatectomy for remnant PC can prolong patient survival, and RAS mutation analysis indicated that many remnant PCs are developed from metachronous multifocal origins.

Original languageEnglish
Pages (from-to)437-448
Number of pages12
JournalJournal of gastroenterology
Volume54
Issue number5
DOIs
Publication statusPublished - May 1 2019

Fingerprint

Pancreatectomy
Pancreatic Neoplasms
Multicenter Studies
Pancreas
Retrospective Studies
Neoplasms
Mutation
Clinical Studies
Ductal Carcinoma
Survival

All Science Journal Classification (ASJC) codes

  • Gastroenterology

Cite this

Pancreatic cancer arising from the remnant pancreas after pancreatectomy : a multicenter retrospective study by the Kyushu Study Group of Clinical Cancer. / Hashimoto, Daisuke; Arima, Kota; Nakagawa, Shigeki; Negoro, Yuji; Hirata, Toshihiko; Hirota, Masahiko; Inomata, Masafumi; Fukuzawa, Kengo; Ohga, Takefumi; Saeki, Hiroshi; Oki, Eiji; Yamashita, Yo ichi; Chikamoto, Akira; Baba, Hideo; Maehara, Yoshihiko.

In: Journal of gastroenterology, Vol. 54, No. 5, 01.05.2019, p. 437-448.

Research output: Contribution to journalArticle

Hashimoto, D, Arima, K, Nakagawa, S, Negoro, Y, Hirata, T, Hirota, M, Inomata, M, Fukuzawa, K, Ohga, T, Saeki, H, Oki, E, Yamashita, YI, Chikamoto, A, Baba, H & Maehara, Y 2019, 'Pancreatic cancer arising from the remnant pancreas after pancreatectomy: a multicenter retrospective study by the Kyushu Study Group of Clinical Cancer', Journal of gastroenterology, vol. 54, no. 5, pp. 437-448. https://doi.org/10.1007/s00535-018-01535-9
Hashimoto, Daisuke ; Arima, Kota ; Nakagawa, Shigeki ; Negoro, Yuji ; Hirata, Toshihiko ; Hirota, Masahiko ; Inomata, Masafumi ; Fukuzawa, Kengo ; Ohga, Takefumi ; Saeki, Hiroshi ; Oki, Eiji ; Yamashita, Yo ichi ; Chikamoto, Akira ; Baba, Hideo ; Maehara, Yoshihiko. / Pancreatic cancer arising from the remnant pancreas after pancreatectomy : a multicenter retrospective study by the Kyushu Study Group of Clinical Cancer. In: Journal of gastroenterology. 2019 ; Vol. 54, No. 5. pp. 437-448.
@article{206c9c4a6c5b440aa068ede00bbc4d5c,
title = "Pancreatic cancer arising from the remnant pancreas after pancreatectomy: a multicenter retrospective study by the Kyushu Study Group of Clinical Cancer",
abstract = "Background: After initial pancreatic resection, local recurrence of pancreatic cancer (PC) or new primary PC can develop in the remnant. There are limited data available regarding this so-called remnant PC. The aim of this retrospective study was to clarify the clinical features and establish a treatment strategy for remnant PC. Methods: A multicenter retrospective study with the Kyushu Study Group of Clinical Cancer was carried out. Clinical data from 50 patients who developed remnant PC were analyzed. RAS mutation analysis of the initial tumor and of remnant PC was performed in 17 cases. Results: The initial pancreatic resections were performed for 37 invasive ductal carcinomas, and for 13 other tumors. Thirty-seven patients underwent a second pancreatectomy for remnant PC (resected group), while thirteen patients were not operated (unresected group). The median overall survival times were 42.2 months in the resected group and 12.3 months in the unresected group (HR 0.374; 95{\%} CI 0.17–0.83). In RAS mutation analysis, 14 cases had at least 1 missense variant of KRAS, HRAS, or NRAS in the initial pancreatic tumor and/or remnant PC. The same missense variants between the initial tumor and remnant PC were discovered only in KRAS of one patient, and in HRAS of one patient. No case had completely consistent missense variants between the initial tumor and remnant PC. Conclusions: This study found that repeated pancreatectomy for remnant PC can prolong patient survival, and RAS mutation analysis indicated that many remnant PCs are developed from metachronous multifocal origins.",
author = "Daisuke Hashimoto and Kota Arima and Shigeki Nakagawa and Yuji Negoro and Toshihiko Hirata and Masahiko Hirota and Masafumi Inomata and Kengo Fukuzawa and Takefumi Ohga and Hiroshi Saeki and Eiji Oki and Yamashita, {Yo ichi} and Akira Chikamoto and Hideo Baba and Yoshihiko Maehara",
year = "2019",
month = "5",
day = "1",
doi = "10.1007/s00535-018-01535-9",
language = "English",
volume = "54",
pages = "437--448",
journal = "Journal of Gastroenterology",
issn = "0944-1174",
publisher = "Springer Japan",
number = "5",

}

TY - JOUR

T1 - Pancreatic cancer arising from the remnant pancreas after pancreatectomy

T2 - a multicenter retrospective study by the Kyushu Study Group of Clinical Cancer

AU - Hashimoto, Daisuke

AU - Arima, Kota

AU - Nakagawa, Shigeki

AU - Negoro, Yuji

AU - Hirata, Toshihiko

AU - Hirota, Masahiko

AU - Inomata, Masafumi

AU - Fukuzawa, Kengo

AU - Ohga, Takefumi

AU - Saeki, Hiroshi

AU - Oki, Eiji

AU - Yamashita, Yo ichi

AU - Chikamoto, Akira

AU - Baba, Hideo

AU - Maehara, Yoshihiko

PY - 2019/5/1

Y1 - 2019/5/1

N2 - Background: After initial pancreatic resection, local recurrence of pancreatic cancer (PC) or new primary PC can develop in the remnant. There are limited data available regarding this so-called remnant PC. The aim of this retrospective study was to clarify the clinical features and establish a treatment strategy for remnant PC. Methods: A multicenter retrospective study with the Kyushu Study Group of Clinical Cancer was carried out. Clinical data from 50 patients who developed remnant PC were analyzed. RAS mutation analysis of the initial tumor and of remnant PC was performed in 17 cases. Results: The initial pancreatic resections were performed for 37 invasive ductal carcinomas, and for 13 other tumors. Thirty-seven patients underwent a second pancreatectomy for remnant PC (resected group), while thirteen patients were not operated (unresected group). The median overall survival times were 42.2 months in the resected group and 12.3 months in the unresected group (HR 0.374; 95% CI 0.17–0.83). In RAS mutation analysis, 14 cases had at least 1 missense variant of KRAS, HRAS, or NRAS in the initial pancreatic tumor and/or remnant PC. The same missense variants between the initial tumor and remnant PC were discovered only in KRAS of one patient, and in HRAS of one patient. No case had completely consistent missense variants between the initial tumor and remnant PC. Conclusions: This study found that repeated pancreatectomy for remnant PC can prolong patient survival, and RAS mutation analysis indicated that many remnant PCs are developed from metachronous multifocal origins.

AB - Background: After initial pancreatic resection, local recurrence of pancreatic cancer (PC) or new primary PC can develop in the remnant. There are limited data available regarding this so-called remnant PC. The aim of this retrospective study was to clarify the clinical features and establish a treatment strategy for remnant PC. Methods: A multicenter retrospective study with the Kyushu Study Group of Clinical Cancer was carried out. Clinical data from 50 patients who developed remnant PC were analyzed. RAS mutation analysis of the initial tumor and of remnant PC was performed in 17 cases. Results: The initial pancreatic resections were performed for 37 invasive ductal carcinomas, and for 13 other tumors. Thirty-seven patients underwent a second pancreatectomy for remnant PC (resected group), while thirteen patients were not operated (unresected group). The median overall survival times were 42.2 months in the resected group and 12.3 months in the unresected group (HR 0.374; 95% CI 0.17–0.83). In RAS mutation analysis, 14 cases had at least 1 missense variant of KRAS, HRAS, or NRAS in the initial pancreatic tumor and/or remnant PC. The same missense variants between the initial tumor and remnant PC were discovered only in KRAS of one patient, and in HRAS of one patient. No case had completely consistent missense variants between the initial tumor and remnant PC. Conclusions: This study found that repeated pancreatectomy for remnant PC can prolong patient survival, and RAS mutation analysis indicated that many remnant PCs are developed from metachronous multifocal origins.

UR - http://www.scopus.com/inward/record.url?scp=85057768282&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85057768282&partnerID=8YFLogxK

U2 - 10.1007/s00535-018-01535-9

DO - 10.1007/s00535-018-01535-9

M3 - Article

VL - 54

SP - 437

EP - 448

JO - Journal of Gastroenterology

JF - Journal of Gastroenterology

SN - 0944-1174

IS - 5

ER -