How would you approach oligometastatic (solitary) recurrence with previously resected pancreatic adenocarcinoma and adjuvant chemotherapy with a prolonged disease-free interval?  

This is very different from colon cancer with a solitary recurrence after a long disease-free interval. In this case, before considering any local therapy, I would treat with a course of systemic therapy to establish favorable disease biology. The vast majority of patients with recurrent, ...

I think it depends on the interval of time between end of treatment and recurrence.  For most patients, recurrence will occur within the first few years after completing adjuvant therapy, and for those patients, systemic therapy is the most appropriate course.  However, occasionally there ...

Was it Ampullary Ca? Some of these are BRCA enriched and NGS testing can be helpful.