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Pancreatic Cancer Arising From the Remnant Pancreas: Is It a Local Recurrence or New Primary Lesion?

Hashimoto, Daisuke MD, PhD*; Chikamoto, Akira MD*; Masuda, Toshiro MD, PhD*; Nakagawa, Shigeki MD, PhD*; Imai, Katsunori MD, PhD*; Yamashita, Yo-ichi MD, PhD*; Reber, Howard A. MD; Baba, Hideo MD, PhD*

doi: 10.1097/MPA.0000000000000897
Reviews

Local recurrence of pancreatic cancer (PC) can occur in the pancreatic remnant. In addition, new primary PC can develop in the remnant. There are limited data available regarding this so-called remnant PC. The aim of this review was to describe the characteristics and therapeutic strategy regarding remnant PC. A literature search was performed using Medline published in English according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The incidence of remnant PC has been reported to be 3% to 5%. It is difficult to distinguish local recurrence from new primary PC. Genetic diagnosis such as Kirsten rat sarcoma viral oncogene homolog mutation may resolve this problem. For patients with remnant PC, repeated pancreatectomy can be performed. Residual total pancreatectomy is the most common procedure. Recent studies have described the safety of the operation because of recent surgical progress and perioperative care. The patients with remnant PC without distant metastasis have shown good long-term outcomes, especially those who underwent repeated pancreatectomy. Adjuvant chemotherapy may contribute to longer survival. In conclusion, this review found that both local recurrence and new primary PC can develop in the pancreatic remnant. Repeated pancreatectomy for the remnant PC is a feasible procedure and can prolong patient survival.

From the *Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan; and †Department of Surgery, David Geffen School of Medicine, UCLA, Los Angeles, CA.

Received for publication October 9, 2016; accepted July 5, 2017.

Address correspondence to: Hideo Baba, MD, PhD, Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Kumamoto City 860-8556, Japan (e-mail: hdobaba@kumamoto-u.ac.jp).

The authors declare no conflicts of interest.

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