Characteristics of Lung Metastasis as an Initial Recurrence Pattern After Curative Resection of Pancreatic Cancer

Objectives Understanding the disparity in clinical course because of differences in initial recurrence patterns could lead to a more accurate estimation of prognosis and optimal treatment. Methods Patients who underwent resection for pancreatic cancer between January 2003 and December 2016 were identified from a prospective database. We analyzed the association between clinicopathological information or survival outcomes and initial recurrence patterns. Results The most frequent recurrence pattern was locoregional recurrence (n = 84, 31.3%), followed by simultaneous multiple recurrences (n = 65, 24.2%), liver metastasis (n = 53, 19.8%), peritoneal dissemination (n = 41, 15.3%), and lung metastasis (n = 20, 7.5%). In addition, survival outcomes were significantly longer in the lung metastasis group than in the other recurrence pattern group (recurrence-free survival, 18.2 vs 8.2 months,P< 0.001; overall survival, 86.4 vs 21.0 months,P< 0.001; and survival after recurrence, 37.1 vs 9.3 months,P< 0.001). The lung metastasis group had a significantly higher proportion of pancreatic body and tail cancer (P< 0.002) and arterial invasion (P= 0.006) than the other recurrence pattern group. Conclusions Lung metastasis as an initial recurrence pattern frequently occurred in patients with body and tail cancer and patients with arterial invasion.