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CT imaging of early local recurrence of pancreatic adenocarcinoma following pancreaticoduodenectomy

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Abstract

Purpose

The objectives of this retrospective study were to describe the characteristics and topography of pancreatic ductal adenocarcinoma and its early local recurrence after pancreaticoduodenectomy and identify predictive factors of local early recurrence by imaging computed tomography (CT).

Methods

The institutional review board approved the study and did require additional informed consent for reviewing the patients’ medical records and images. Patients who underwent pancreaticoduodenectomy for ductal adenocarcinoma, a preoperative CT scan, and adequate postoperative CT were included. After postoperative imaging, correlations among clinical and histological characteristics and preoperative imaging were evaluated.

Results

Among the 123 patients who underwent pancreaticoduodenectomy, 48 patients had sufficient follow-up imaging and were included in this study. A total of 33 patients experienced local early recurrence (Group 1), and 15 exhibited no local recurrence (Group 2). Local recurrence consisted of two types of anomalies: tissue nodules on surgical clips (94 %) and peri-arterial encasement (82 %). On preoperative imaging, the tumor diameter (p = 0.02) and the presence of a venous borderline resectable tumor (p < 0.0001) were predictive of local recurrence.

Conclusions

Tissue nodules on surgical clips and arterial encasement characterize early local recurrence, and nodules and encasement should not be considered common post-operative infiltration. The role of the radiologist is essential to assess the predictive factors of recurrence and to identify early local recurrence.

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Authors and Affiliations

  1. Department of Radiology Adults, Brabois Hospital, University of Nancy, Rue du Morvan, 54 511, Vandoeuvre les Nancy, France

    Clémence Balaj, Alexandre Oliver, François Jausset, Caroline Sellal, Michel Claudon & Valérie Laurent

  2. Department of HBP Surgery, Brabois Hospital, University of Nancy, Vandoeuvre les Nancy, France

    Ahmet Ayav

Authors
  1. Clémence Balaj
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  2. Ahmet Ayav
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  3. Alexandre Oliver
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  4. François Jausset
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  5. Caroline Sellal
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  6. Michel Claudon
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  7. Valérie Laurent
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Correspondence to Clémence Balaj.

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The authors declare that they have no conflict of interest.

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Cite this article

Balaj, C., Ayav, A., Oliver, A. et al. CT imaging of early local recurrence of pancreatic adenocarcinoma following pancreaticoduodenectomy. Abdom Radiol 41, 273–282 (2016). https://doi.org/10.1007/s00261-015-0564-z

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  • DOI: https://doi.org/10.1007/s00261-015-0564-z

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