Impact of liver disease and parenchymal changes on patterns of liver recurrence in patients with resected PDAC: a new insight into the biological behavior of this lethal disease

Presenter: Ammar Javed MD | Johns Hopkins University School of Medicine Background: Premetastatic niche formation in the liver resulting from signaling primary pancreatic ductal adenocarcinoma (PDAC), is suggested to play an important role metastatic spread liver. The impact preexisting disease or parenchymal changes (LD) on rates metastasis PDAC remains unexplored. Methods: A prospectively maintained institutional pancreatectomy registry was used identify patients who underwent resection between 2010 and 2017. Clinicopathological data were extracted analyzed. Patient records reviewed LD. Results: Of 1,193 patients, 257 (21.5%) had LD; well balanced terms clinicopathological treatment characteristics as compared non-LD patients. On multivariable analysis presence LD independently associated with liver-specific recurrence free survival (LS-RFS) (p = 0.006). rate 1-year (76.3 vs. 84.2%) 2-year (65.8% 76.9%) LS-RFS higher 0.022). No difference observed median extra-hepatic RFS two groups (LD non-LD: 24.3 months 23.0 months, p 0.527). overall hepatic 30.6%, 26.8% type-1 (fatty perfusion changes), 6.8% type-2 (cirrhosis, fibrosis, granulomatous disease, textural changes, etc.) (p<0.001) (Figure). Conclusion: Presence type development PDAC. This suggests that could affect premetastatic PDAC, further studies are required elucidate mechanisms involved.