Multimodality treatment of recurrent pancreatic cancer: Mith or reality?

Table 1 Review of recent works on redo surgery for ductal adenocarcinoma local recurrence

Ref.	Year	n	DFI(mo)	Site of recurrence	Surgery	Associated procedure	Morbidity	Mortality	SPR	OS
Dalla Valle et al[36]	2006	1	18	1 panc remnant	1 RP	Distal gastrectomy, segmentary resection of transverse colon, splenectomy, extended lymph node dissection	0	0	24	42
Kleeff et al[35]	2007	12	13	8 local 2 local + stomach 2 local + mesentery	11 resection 1 partial gastrectomy	4 IORT 1 right hemicolectomy	NA	NA	13	NA
Koizumi et al[37]	2010	2	83 28	2 panc remnant	2 RP	/	NA	0	10 8	93 36
Lavu et al[33]	2011	8	27.5	8 panc remnant	8 RP	1 subtotal gastrectomy	(2/8) 25%	0	15	74
Thomas et al[34]	2012	7	41.1	1 abdominal wall 5 panc remnant 1 resection bed	2 resection 5 RP	NA	NA	0	NA	79.3
Kobayashi et al[38]	2012	1	36	1 panc remnant	1 RP	Partial pancreas autotransplantation	0	0	20
Boone et al[39]	2013	10	25.3	3 resection bed 2 pancr remnant, small bowel 1 pancr remnant, colon 1 pancr remnant, small bowel, stomach 3 stomach	3 resection pancreatic bed mass 4 RP 2 partial gastrectomy 1 SBR	3 SBR 1 partial gastrectomy + splenectomy 1 partial colectomy	NA	0	32.4	59.1
Miyazaki et al[4]	2014	11	32	11 pancr remnant	11 RP	1 celicac resection + total gastrectomy 1 portal vein resection	(3/11) 27%	0	25	78.2
Total		62	27.5 (me)				/	0	17.5 (me)	66.55 (me)

DFI: Disease free interval (from primary pancreatic resection); RP: Repeat pancreatectomy; SBR: Small bowel resection; SPR: Survival post-reoperation; OS: Overall survival after initial pancreatectomy; NA: Not applicable; me: Median; IORT: Intraoperative radiation therapy.

Table 2 Review of recent works on redo surgery for ductal adenocarcinoma metastatic recurrence

Ref.	Year	n	DFI (mo)	Site of recurrence	Surgery	Associated procedure	Morbidity	Mortality	SPR	OS
Kleeff et al[35]	2007	2	15.5	2 liver	1 left hemihepatectomy 1 right hemihepatectomy	/	NA	NA	23.5	NA
Arnaoutakis et al[40]	2011	9	34	9 lung	10 lung resection	/	1 AF	0	18.6	51
Thomas et al[34]	2012	14	52.4 (LR) 7.6 (LiR)	1 brain 6 liver 7 lung	4 RFA 10 resection	/	NA	0	NA	92.3 (LR); 32.5 (LiR)
Boone et al[39]	2013	12	34.35 (LR) 17 (LiR) 7.6 (Ovary)	6 liver 5 lung 1 ovary	4 liver resection 2 RFA 5 lung resection 1 hysterectomy + BSO	2 RFA	NA	0	20.1 (LR) 13.9 (LiR) 12.7 (ovary)	70.8 (LR) 29.8 (LiR) 20.3 (ovary)
Total		37	25.5 (me)	14 liver 21 lung 1 brain 1 ovary				0	18.6 (me)	41.75 (me)

DFI: Disease free interval; SPR: Survival post-reoperation; OS: Overall survival; LR: Lung recurrence; LiR: Liver recurrence; AF: Atrial fibrillation; RFA: Radiofrequency ablation; BSO: Bilateral salpingo-oophorectomy; NA: Not applicable; me: Median.