Introduction : Pancreatic ductal adenocarcinoma(PDAC) is regarded as incurable, since its survival rate is still limited even after curative resection. Factors that predict long-term survival are controversial. Also, it is uncertain that 5 disease-free years means cure of PDAC. The aim of this study is to identify factors associated with long-term survival and determine if 5-year period means confirmation of cure.

Methods : Between January 2007 to December 2014, a total of 625 patients underwent resection for PDAC. The clinicopathological data of the patients were retrospectively reviewed. Risk factor analyses were performed to identify the factors associated with actual 5-year overall and disease-free survival. The characteristics of patients who had recurrent disease after postoperative 5 years were reviewed separately.

Results : The actual 5-year overall and disease-free survival rates of total patients were 19.4% and 19.3%, respectively. Long-term survivors (n=89) had a median survival of 84 months. Age and lymph node metastasis were related to long-term survival. In patients with disease-free survival beyond 5 years (n=68), age, tumor size, and lymph node metastasis were associated factors. Among those, recurrent cancer had occurred in 6 patients: 3 loco-regional recurrences, 3 distant metastases. There was no statistically significant factor in these patients comparing to the other 62 patients.

Conclusions : In this study, 89 of total 625 patients have survived longer than 5 years. There still remains risk of recurrence after 5 disease-free years, but no specific factor was identified to be predict the risk. This demonstrates that 5-year period may not guarantee cure of PDAC.