A soft tissue mass around the arteries after pancreatectomy: the association with local recurrence and the impact of neoadjuvant radiotherapy in pancreatic ductal adenocarcinoma.

PURPOSE: The presence of a soft tissue mass (STM) around the arteries is often observed after pancreatectomy. Although a STM frequently represents local recurrence, it can also reflect benign postoperative changes. However, the frequency of STMs and the factors determining whether its presence leads to local recurrence or remains benign have not been studied. This study aimed to determine the frequency of STM after pancreatectomy and to identify the clinical factors associated with the development of local recurrence.

METHODS

A total of 246 patients who underwent pancreatectomy at a single institution were analyzed retrospectively. The presence of a STM was assessed by follow-up computed tomography, and its association with local recurrence was evaluated.

RESULTS

Among the 246 patients, 33 (13.4%) developed STM after pancreatectomy, and all cases occurred in patients with pancreatic ductal adenocarcinoma (PDAC). Among the 133 patients who underwent pancreatectomy for PDAC, 33 (24.8%) developed STM, 23 (69.7%) of which progressed to local recurrence. No significant predictive factors for STM occurrence were identified in the PDAC patients. However, among the PDAC patients with STM, those who had received neoadjuvant radiotherapy were significantly less likely to develop local recurrence than those who had not (P = 0.0259).

CONCLUSION

STMs occurred after pancreatectomy only in patients with PDAC, and neoadjuvant radiotherapy may influence whether the STM progresses to local recurrence, although the sample size was limited. No predictive factors associated with the development of STMs in patients with PDAC were identified.