Serum SPan-1 Is a Significant Risk Factor for Early Recurrence of Pancreatic Cancer after Curative Resection.

Background/aims: Curative resection is still the only treatment for patients with pancreatic ductal adenocarcinoma (PDAC). However, early postoperative recurrence occurs frequently. The aim of this study was to investigate the predictors of early recurrence of PDAC.

Methods: Clinical data of 172 consecutive patients with PDAC who underwent curative resection (R0) between 2000 and 2015 at Tokyo Medical University Hospital were retrospectively analyzed.

Results: The median follow-up period was 18.2 months. Recurrence occurred in 96 of 172 (55.8%) patients, 27 in whom recurrence occurred within 6 months (early recurrence). Median survival time of the early recurrence group was 10.7 months. The optimal cutoff concentrations for the prediction of early recurrence were 111.3 U/ml, 3.0 ng/ml, 41 U/ml and 670 U/ml for CA19-9, carcinoembryonic antigen, SPan-1 and DUPAN-2, respectively. Multivariate analysis demonstrated that a SPan-1 concentration of >41 U/ml, having received neoadjuvant therapy and having never received adjuvant chemotherapy were significant and independent predictors of early recurrence.

Conclusion: A preoperative SPan-1 concentration of >41 U/ml is a significant and independent predictor of the early recurrence of pancreatic adenocarcinoma.