Risk Factors for Early Liver Recurrence After Pancreatic Cancer Resection

Background: Liver recurrence after resection is one of the most common types of recurrence and is a risk factor for poor prognosis. The aim of this study was to identify risk factors for initial liver recurrence. Materials and Methods: A total of 109 patients with resectable pancreatic ductal adenocarcinoma who underwent resection between 2015 and 2022 were included. The influence of clinicopathologic variables on liver recurrence was analyzed to create a novel scoring system to predict liver recurrence. Results: The liver recurrence rate was 24%, with 17% recurrence within 1 year. Patients with liver recurrence had an extremely poor prognosis within 1 year (MST 12.4 [95% CI, 5.7-19.1]). In multivariate analysis, R-PV, large tumor diameter ≥45 mm, and venous invasion were independent risk factors for early liver recurrence. When each of these risk factors was scored as 1 point, the 1-year liver recurrence rates by score were 0 (0%), 1 (9%), 2 (30%), and 3 (84%). Conclusion: The risk factors for postoperative early liver recurrence were R-PV, a tumor diameter ≥45 mm, and pathological venous invasion. Surgery for pancreatic cancer with these factors may require special treatment, such as hepatic arterial injection.