{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T15:22:32Z","timestamp":1781191352608,"version":"3.54.1"},"reference-count":36,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Reports"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>This study aims to analyze the risk factors for local recurrence (LR) following pancreaticoduodenectomy (PD) in pancreatic cancer patients and to identify vascular features associated with this outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Background<\/jats:title><jats:p>Pancreatic cancer frequently involves the mesenteric root, particularly the Porto\u2010mesenteric vein (PV\u2010SMV), impacting survival post curative surgery. However, the relationship between vascular structural changes and LR post\u2010operation remains unclear.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective data collection was conducted at a single tertiary center from December 2010 to March 2021. Clinical characteristics, surgical\u2010pathological factors, and radiological features were compiled.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 203 pancreatic cancer cases undergoing PD were analyzed, with 72 (35.5%) undergoing concurrent PV\u2010SMV resection (VR). Median overall survival post\u2010operation was 22.4\u2009months. LR occurred in 121 patients (60%) at a median time of 8\u2009months postoperatively. Resectable disease exhibited significantly longer local\u2010recurrence free survival compared to borderline resectable\/locally advanced pancreatic cancer (BRPC\/LAPC) (median 14.5 vs. 7\u2009months, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). The most frequent sites of LR were the mesenteric root (37%), superior mesenteric artery (SMA, 21%), and superior mesenteric vein (SMV, 16%), with similar patterns observed in the VR and non\u2010VR groups. BRPC, LAPC, postoperative CA19\u20109 above normal range, venous thrombosis, and stenosis were associated with LR (HR: 2.1 [95% CI 1.21\u20133.68], 2.7 [95% CI 1.6\u20134.71], 1.8 [95% CI 1.21\u20132.69], 2.0 [95% CI 1.08\u20133.92], and 1.6 [95% CI 1.0\u20132.65], respectively), while PV\u2010SMV resection and enlargement of PV\u2010SMV angle were protective factors (HR: 0.4 [95% CI 0.25\u20130.67] and 0.3 [95% CI 0.19\u20130.53]).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Despite aggressive treatment strategies including neoadjuvant therapy and radical surgery, LR in pancreatic cancer remains a challenge. This study highlights potential risk factors, recurrence patterns, and associated vascular features for early identification. These findings may guide clinicians in developing more targeted surveillance strategies and inform future research on preventing LR.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cnr2.70267","type":"journal-article","created":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T06:34:42Z","timestamp":1751351682000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Risk Factors and Vascular Features Associated With Local Recurrence in Pancreatic Cancer Post\u2010Pancreaticoduodenectomy: A Retrospective Cohort Study"],"prefix":"10.1002","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4742-8066","authenticated-orcid":false,"given":"Ting\u2010Kai","family":"Liao","sequence":"first","affiliation":[{"name":"Department of Surgery National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University  Tainan Taiwan"},{"name":"Institute of Clinical Medicine, College of Medicine, National Cheng Kung University  Tainan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-8245-2936","authenticated-orcid":false,"given":"Ying Jui","family":"Chao","sequence":"additional","affiliation":[{"name":"Department of Surgery National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University  Tainan Taiwan"},{"name":"Institute of Clinical Medicine, College of Medicine, National Cheng Kung University  Tainan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-0462-9757","authenticated-orcid":false,"given":"Wei\u2010Hsun","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Surgery National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University  Tainan Taiwan"},{"name":"Institute of Clinical Medicine, College of Medicine, National Cheng Kung University  Tainan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-4941-7175","authenticated-orcid":false,"given":"Ping\u2010Jui","family":"Su","sequence":"additional","affiliation":[{"name":"Department of Surgery National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University  Tainan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7625-2891","authenticated-orcid":false,"given":"Chih\u2010Jung","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Surgery National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University  Tainan Taiwan"},{"name":"Institute of Clinical Medicine, College of Medicine, National Cheng Kung University  Tainan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2457-5189","authenticated-orcid":false,"given":"Yan\u2010Shen","family":"Shan","sequence":"additional","affiliation":[{"name":"Department of Surgery National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University  Tainan Taiwan"},{"name":"Institute of Clinical Medicine, College of Medicine, National Cheng Kung University  Tainan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,7]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-020-09568-2"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-015-3096-3"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-017-5810-x"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000004267"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41571-023-00746-1"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00261-023-04012-x"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.acra.2018.07.025"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00261-017-1290-5"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.5334\/aogh.4019"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-016-5515-6"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pan.2015.09.008"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hbpd.2018.09.003"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v17.i9.1126"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00261-018-1765-z"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejrad.2018.07.010"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e318237872e"},{"key":"e_1_2_12_18_1","volume-title":"R: A Language and Environment for Statistical Computing","author":"Team RC","year":"2023"},{"key":"e_1_2_12_19_1","unstructured":"T.Therneau A Package for Survival Analysis in R. 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