BACKGROUND: Hepatic metastases, by far the most common site of pancreatic ductal adenocarcinoma (PC) metastases, are involved in 50-62% of failures after operative resection. Metastatic recurrence, not loco-regional recurrence, is the most important determinant of poor survival after pancreatoduodenectomy (PD). HYPOTHESIS/AIM: We hypothesized that patients who develop early hepatic recurrence after PD for PC have unique preoperative and tumor characteristics but similarly “successful” resections when compared to patients who have relatively greater recurrence-free survival. Our aim was to compare preoperative factors and tumor characteristics between patients with early hepatic recurrence versus those with extended recurrence-free intervals. METHODS: We reviewed 599 patients who underwent PD for PC at our institution from 1981 to 2007; 75 patients developed liver recurrence within 8 months of PD. These patients were matched by age, sex, and era of PD to a reference group consisting of 75 patients whose recurrence-free survival exceeded our entire cohort’s median recurrence-free survival of 15 months. Comparisons of preoperative and tumor characteristics were evaluated using Wilcoxon rank sum, Chi-square, and Fisher’s exact tests. RESULTS: Preoperative jaundice, weight loss, abdominal pain, ASA score, BMI, and use of neoadjuvant or adjuvant therapy were not different between patients with early liver recurrence versus the reference group (all p>0.08). In terms of tumor-related factors, patients with early liver recurrence had larger and higher grade neoplasms at PD compared to the reference group (p=0.005 and 0.026, respectively). Other tumor characteristics, including tumor stage and nodal metastases were not different between patients with early liver recurrence and the reference group (p=0.10 and 0.87, respectively). R0 resection rates were not different between patients with early liver recurrence and the reference group (p=0.56) CONCLUSIONS: Patients who develop liver recurrence within 8 months of PD for PC have larger and higher grade neoplasms compared to patients with recurrence-free survival greater than 15 months. Development of early liver recurrence is not related to the presence of higher stage neoplasms, nodal metastases, or lack of curative (R0) resection at the time of PD. Identification of these and other factors that are unique in the development of early liver recurrence may offer an opportunity for novel adjuvant treatment strategies for patients with PC.