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Pancreatic cancer in the remnant pancreas following primary pancreatic resection

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Abstract

Purpose

To clarify the clinical features of cancer in the pancreatic remnant.

Methods

We retrospectively reviewed the clinical and pathological findings of 10 patients who developed remnant pancreatic cancer in our hospital between 2002 and 2012. The KRAS sequences in both the initial pancreatic tumor and remnant pancreatic cancer were examined in two patients.

Results

Eight patients underwent a second pancreatectomy for remnant pancreatic cancer (resected group), while two patients were not operated on and underwent chemotherapy (unresected group). The remnant pancreatic cancer developed at the cut end of the pancreas (pancreaticogastrostomy site) in four patients. In the resected group, four patients died 17 months after the emergence of the remnant pancreatic cancer and four patients survived during the median 40.5-month observation period. The median survival of the unresected group after the emergence of the remnant pancreatic cancer was 10 months. The findings of the KRAS sequencing and immunohistological staining of the remnant pancreatic cancer for MUC1 and MUC2 in the two patients were consistent with those of the initial pancreatic tumor in one patient, and not consistent in the other.

Conclusions

Our results suggest that both local recurrence and a new primary cancer can develop in the pancreatic remnant, and repeated pancreatectomy can prolong survival.

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Conflict of interest

The authors declare that they have no conflicts of interest.

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Authors and Affiliations

  1. Department of Gastroenterological Surgery, Kumamoto University Graduate School of Medical Sciences, 1-1-1 Honjo, Kumamoto, 860-8556, Japan

    Daisuke Hashimoto, Akira Chikamoto, Kazuya Sakata, Keisuke Miyake, Hideyuki Kuroki, Masayuki Watanabe, Toru Beppu & Hideo Baba

  2. Institute of Resource Development and Analysis, Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan

    Masaki Ohmuraya

  3. Department of Surgery, Kumamoto Regional Medical Center, Kumamoto, Japan

    Masahiko Hirota

Authors
  1. Daisuke Hashimoto
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  2. Akira Chikamoto
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  3. Masaki Ohmuraya
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  4. Kazuya Sakata
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  5. Keisuke Miyake
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  6. Hideyuki Kuroki
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  7. Masayuki Watanabe
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  8. Toru Beppu
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  9. Masahiko Hirota
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  10. Hideo Baba
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Corresponding author

Correspondence to Hideo Baba.

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Hashimoto, D., Chikamoto, A., Ohmuraya, M. et al. Pancreatic cancer in the remnant pancreas following primary pancreatic resection. Surg Today 44, 1313–1320 (2014). https://doi.org/10.1007/s00595-013-0708-0

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  • DOI: https://doi.org/10.1007/s00595-013-0708-0

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