3716 - Prognostic factors for predicting early recurrence within the first year of surgery in pancreatic ductal adenocarcinoma

Background

Pancreatic ductal adenocarcinoma (PDAC) has a dismal prognosis and it is a lethal disease with a recurrence rate of almost 50% within 1 year even after curative resection. The purpose of this study was to find out risk factors of early recurrence within the first year of surgery in PDAC.

Methods

From January 2007 to December 2016, 833 patients who underwent pancreatectomy with curative intention for PDAC at a single institute were included in this study, and their medical records were retrospectively reviewed.

Results

The median overall survival (OS) was 22.1 months and the median disease free survival(DFS) was 10.4 months. The 5-year OS rate was 25.9% and DFS rate was 18.6%. After excluding 80 patients who have lost to follow-up, there were 394 patients (54.0%) who have recurred within the first year of surgery. Multivariable logistic regression revealed that the followings were independently associated with early recurrence: neutrophil to lymphocyte ratio > 2.7 (odds ratio [OR] 1.684, 95% confidence interval [CI] 1.164 - 2.436), poorly or un-differentiated tumor(OR 2.421, 95% CI 1.678 - 3.492), T stage (T2 [OR 2.082, 95% CI 1.384 - 3.134], T3 [OR 4.577, 95% CI 2.589 - 8.091]), and N stage (N1 [OR 1.560, 95% CI 1.075 - 2.265], N2 [OR 4.561, 2.831 - 7.348]). Adjuvant chemoradiation therapy was a factor that reduces the risk of early recurrence (OR 0.552, 95% CI 0.386 - 0.789).

Conclusions

Identification of risk factors associated with early recurrence in the preoperative and postoperative state may help establish therapeutic strategies to reduce the recurrence rate and improve survival of PDAC patients.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.