Tumor location in the pancreatic body/tail as an independent risk factor for early recurrence after curative resection of pancreatic ductal adenocarcinoma: a single-center retrospective study

Background Early recurrence after radical resection of pancreatic ductal adenocarcinoma (PDAC) is a primary cause of poor prognosis. Published definitions of early recurrence use postoperative cutoff points ranging from 6 to 12 months. This study aimed to analyze perioperative clinicopathological features associated with early recurrence after PDAC surgery, with particular focus on the impact of tumor location, to facilitate individualized treatment decisions. Methods Clinical data from 155 patients with PDAC who underwent pancreatectomy at Panjin Liao-Oil Field Gem Flower Hospital between January 2011 and December 2020 were retrospectively analyzed. In this study, early recurrence was defined as recurrence within 6 months after surgery. Kaplan-Meier method with log-rank test was used to evaluate survival outcomes. Two separate multivariable logistic regression models were constructed to identify independent predictors of early recurrence: one including preoperative variables and one including postoperative variables. Odds ratios (ORs) with 95% confidence intervals (CIs) were reported for these logistic regression models. Results The R0 resection rate was significantly higher for pancreatic body/tail tumors than for head/neck tumors ( P = 0.040). Among 155 patients, 55 (35.5%) developed recurrence within 6 months (early recurrence group), 78 (50.3%) had non-early recurrence, and 22 (14.2%) showed no recurrence. The early recurrence group had a significantly higher proportion of multiple-organ metastasis ( P = 0.019) and significantly shorter overall survival ( P < 0.001). No significant differences in recurrence patterns or overall survival were observed between tumor location subgroups ( P > 0.05). In the preoperative multivariable model, only CA19-9 ≥ 208 IU/mL was an independent predictor of early recurrence ( P = 0.021); body/tail location was not statistically significant ( P = 0.123). In the postoperative multivariable model, body/tail tumor location, tumor size ≥ 3.3 cm (based on postoperative pathological measurement), TNM stage III, and lack of postoperative adjuvant chemotherapy were independent risk factors for recurrence within 6 months ( P < 0.05). Conclusions In this single-center retrospective cohort, body/tail tumor location was associated with early recurrence within 6 months after curative-intent PDAC surgery in the postoperative multivariable model, but it was not independently significant in the preoperative model and did not significantly affect overall survival. This finding is hypothesis-generating and requires external validation. Incorporating tumor location into preoperative risk stratification may warrant prospective evaluation as one component of a preoperative risk model.