1. Pancreatic cancer arising in the remnant pancreas is not always a relapse of the preceding primary.
- Author
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Luchini C, Pea A, Yu J, He J, Salvia R, Riva G, Weiss MJ, Bassi C, Cameron JL, Hruban RH, Goggins M, Wolfgang CL, Scarpa A, Wood LD, and Lawlor RT
- Subjects
- Baltimore, Biomarkers, Tumor chemistry, Biomarkers, Tumor genetics, Carcinoma, Pancreatic Ductal chemistry, Carcinoma, Pancreatic Ductal genetics, Carcinoma, Pancreatic Ductal surgery, Diagnosis, Differential, Humans, Italy, Neoplasm Recurrence, Local chemistry, Neoplasm Recurrence, Local genetics, Neoplasms, Second Primary chemistry, Neoplasms, Second Primary genetics, Pancreatectomy, Pancreatic Neoplasms chemistry, Pancreatic Neoplasms genetics, Pancreatic Neoplasms surgery, Predictive Value of Tests, Retrospective Studies, Biomarkers, Tumor metabolism, Carcinoma, Pancreatic Ductal pathology, Neoplasm Recurrence, Local pathology, Neoplasms, Second Primary pathology, Pancreatic Neoplasms pathology
- Abstract
This study aimed to understand the biology of pancreatic ductal adenocarcinoma that arises in the remnant pancreas after surgical resection of a primary pancreatic ductal adenocarcinoma, using integrated histological and molecular analysis. Patients who underwent a completion pancreatectomy for local recurrence following resection of a primary pancreatic ductal adenocarcinoma were studied with histological analysis and next-generation sequencing of the primary and the recurrent cancer. Of six patients that met the inclusion criteria, three cases were classified as "true" recurrences, i.e., the primary and the cancer in the remnant pancreas shared both morphological features and molecular alterations. Two cases were identified as having independent cancers that exhibited different histological and molecular profiles. In the remaining case, the relationship could not be determined. Pancreatic ductal adenocarcinoma that arises in the remnant pancreas can be either a second primary or a "true" relapse of the preceding primary. The differentiation of second primaries from local recurrences may have important implications for patient management.
- Published
- 2019
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