Introduction : The study was aimed to examine the incidence, factors associated and long term outcomes following local recurrences(LR) after curative resections for periampullary cancers.

Methods : A retrospective analysis of a prospectively maintained database was undertaken comprising of all patients of periampullary cancers who underwent curative resections from January 2012 to January 2018, at Tata Memorial Hospital, Mumbai India. The incidence and patterns of recurrences were studied, and various factors were analysed to look for association with LR.

Results : A total of 424 patients underwent curative resections for periampullary adenocarcinomas during the study period. With a median follow up of 42 months, 23 patients (5.4%) developed isolated LR, 50 patients (11.8%) developed LR with distant metastases (DM), and 103 patients (24.3%) developed isolated DM. The median OS for patients with LR was 47.9 months, and 24.8 months for patients with DM (p = 0.000). On analysing all patients with LR, tumour subsite (distal common bile duct- CBD), and nodal positivity(p=0.000) were independently associated with higher rates of LR, and advanced T stage (p=0.060) reached near statistical significance. The most common site for LR was along SMA nodal region (52.2%).

Conclusions : Incidence of LR after resection for periampullary cancers is 5.4%; however they have significantly better OS compared to systemic recurrences. Nodal involvement, and higher tumour stage, especially in distal CBD tumours are associated with increased risk of local recurrences. Strategy to prevent local recurrence should involve performance of radical surgery with complete lymphadenectomy along the SMA, celiac and periportal region, especially in advanced T and N stage disease