Is remnant pancreatic cancer after pancreatic resection more frequent in early-stage pancreatic cancer than in advanced-stage cancer?

Aim: As the prognosis of patients who undergo resection for pancreatic cancer has improved, reports of remnant pancreatic cancer after pancreatic cancer resection have been increasing. Previous studies regarding early-stage pancreatic cancer showed a high incidence of remnant pancreatic cancer in these patients. The aim of this study was to investigate the incidence of remnant pancreatic cancer according to the degree of progression of the initial pancreatic cancer.

Methods: Patients who underwent partial pancreatic resection for primary pancreatic cancer were retrospectively reviewed and divided into an early-stage group and an advanced-stage group according to the stage of the initial cancer. Patient characteristics and long-term outcomes, including development of remnant pancreatic cancer, were compared between the two groups.

Results: This study included 321 patients who underwent partial pancreatectomy for pancreatic cancer; 32 patients in the early-stage group and 289 patients in the advanced-stage group. Remnant pancreatic cancer developed in 19 patients (5.9%); seven patients (21.9%) in the early-stage group and 12 patients (4.5%) in the advanced-stage group. The cumulative incidence of remnant pancreatic cancer according to the Kaplan-Meier method was comparable between the two groups (5-year cumulative incidence: 20.6% vs 9.9%, early-stage group vs advanced-stage group; P = .1827).

Conclusion: Our results suggested that the potential for developing remnant pancreatic cancer was comparable between the early-stage and the advanced-stage groups. Therefore, the incidence of remnant pancreatic cancer may increase along with improved pancreatic cancer treatment.