CT diagnosis of recurrence after pancreatic cancer: Is there a pattern?

Table 1 Patient characteristics

Gender	47 male, 30 female
Age	mean 67.8 yr; range, 41-86 yr
T-stage1	4 T2, 70 T3, 1 T4
N-stage1	18 N0, 57 N1
R-stage2	54 R0, 10 R1, 5 R2
Histology	n
Adenocarcinoma of the papilla	5
Ductal adenocarcinoma	65
Mucinous-papillary carcinoma	4
Adenocarcinoma of the bile duct	1
Neuroendocrine carcinoma	1
Acinar cell carcinoma	1
Localization
Papilla	5
Head	59
Body	9
Tail	4
Resection
Whipple	60
Left resection	11
Total pancreatectomy	6

¹In 2 cases TNM-stage was not obtainable from medical records;

²In 8 cases R-status not obtainable from medical records.

Table 2 Types of tumor recurrence: isolated or combined occurrence with other manifestations of recurrence

	Isolated	In combination with				Total
		Local	Lymph node	Liver metastasis	Peritoneal carcinosis
Local recurrence	43		11	5	5	64
Lymph node recurrence	6	11				17
Liver metastasis	5	5			1	11
Peritoneal carcinosis	1	5		1		7
	55					991

¹One manifestation with a combination of local recurrence, liver metastasis and peritoneal carcinosis not listed.

Table 3 Mean tumor marker values at the time of recurrence stratified by type of recurrence

Type of recurrence	Tumor marker
	n	CA 19-9 (U/mL)	n	CEA (μg/L)
Local	32	781.67 ± 2090.28	26	9.95 ± 15.57
Lymph node	5	244.02 ± 413.03	4	3.13 ± 2.35
Liver metastasis	5	6674.80 ± 14338.02	5	18.1 ± 18.26
Local & lymph node	7	399 ± 738.15	6	4.28 ± 4.03
Local & liver metastasis	5	1157.0 ± 1802.0	5	21.88 ± 26.76
Local & peritoneal carcinosis	3	351.0 ± 257.66	2	46.0 ± 39.6

No statistically significant differences in tumor markers between types of recurrence (one-way analysis of variance) except comparison of mean values of carbohydrate antigen 19-9 (CA19-9) for local recurrence and liver metastasis (P = 0.025, Student t-test). CEA: Carcinoembryonic antigen.