Positive lymph node status predicts very early recurrence in pancreatic cancer

Positive lymph node status dramatically increases the risk of very early recurrence—defined as recurrence within three months—after neoadjuvant therapy and curative resection for pancreatic ductal adenocarcinoma. In a cohort of 305 patients, 9.1% experienced this rapid recurrence, which severely impacts overall survival (6 months vs. 40 months). This finding suggests that patients with positive lymph nodes should undergo intensified monitoring and may need earlier adjuvant treatment to mitigate recurrence risks.