INTRODUCTION: This systematic review and meta-analysis aims to characterize the surgically important benefits and complications associated with the use of neoadjuvant chemoradiotherapy for the treatment of both resectable and initially unresectable pancreatic cancer. Studies were identified through a systematic literature search and analyzed by two independent reviewers. Survival, peri-operative complications, death rate, pancreatic fistula rate, and the incidence of involved surgical margins were analyzed and subject to meta-analysis. METHODS: Nineteen studies, involving 2,148 patients were identified. Only cohort studies were included. RESULTS: The meta-analysis found that patients with unresectable pancreatic cancer who underwent neoadjuvant chemoradiotherapy achieved similar survival outcomes to patients with resectable disease, even though only 40% were ultimately resected. Neoadjuvant chemoradiotherapy was not associated with a statistically significant increase in the rate of pancreatic fistula formation or total complications. CONCLUSION: Patients receiving neoadjuvant chemoradiotherapy were less likely to have a positive resection margin, although there was an increase in the risk of peri-operative death.
INTRODUCTION: This systematic review and meta-analysis aims to characterize the surgically important benefits and complications associated with the use of neoadjuvant chemoradiotherapy for the treatment of both resectable and initially unresectable pancreatic cancer. Studies were identified through a systematic literature search and analyzed by two independent reviewers. Survival, peri-operative complications, death rate, pancreatic fistula rate, and the incidence of involved surgical margins were analyzed and subject to meta-analysis. METHODS: Nineteen studies, involving 2,148 patients were identified. Only cohort studies were included. RESULTS: The meta-analysis found that patients with unresectable pancreatic cancer who underwent neoadjuvant chemoradiotherapy achieved similar survival outcomes to patients with resectable disease, even though only 40% were ultimately resected. Neoadjuvant chemoradiotherapy was not associated with a statistically significant increase in the rate of pancreatic fistula formation or total complications. CONCLUSION:Patients receiving neoadjuvant chemoradiotherapy were less likely to have a positive resection margin, although there was an increase in the risk of peri-operative death.
Authors: Ross A Abrams; Andrew M Lowy; Eileen M O'Reilly; Robert A Wolff; Vincent J Picozzi; Peter W T Pisters Journal: Ann Surg Oncol Date: 2009-04-24 Impact factor: 5.344
Authors: May Piperdi; Theodore P McDade; Joon K Shim; Bilal Piperdi; Sidney P Kadish; Mary E Sullivan; Giles F Whalen; Jennifer F Tseng Journal: HPB (Oxford) Date: 2010-04 Impact factor: 3.647
Authors: J F Pingpank; J P Hoffman; E A Ross; H S Cooper; N J Meropol; G Freedman; W H Pinover; T E LeVoyer; A R Sasson; B L Eisenberg Journal: J Gastrointest Surg Date: 2001 Mar-Apr Impact factor: 3.452
Authors: H Golcher; T Brunner; G Grabenbauer; S Merkel; T Papadopoulos; W Hohenberger; T Meyer Journal: Eur J Surg Oncol Date: 2008-01-10 Impact factor: 4.424
Authors: Jason W Denbo; Morgan L Bruno; Jordan M Cloyd; Laura Prakash; Jeffrey E Lee; Michael Kim; Christopher H Crane; Eugene J Koay; Sunil Krishnan; Prajnan Das; Bruce D Minsky; Gauri Varadhachary; Rachna Shroff; Robert Wolff; Milind Javle; Michael J Overman; David Fogelman; Thomas A Aloia; Jean-Nicolas Vauthey; Jason B Fleming; Matthew H G Katz Journal: J Gastrointest Surg Date: 2016-10-11 Impact factor: 3.452
Authors: Avani S Dholakia; Amy Hacker-Prietz; Aaron T Wild; Siva P Raman; Laura D Wood; Peng Huang; Daniel A Laheru; Lei Zheng; Ana De Jesus-Acosta; Dung T Le; Richard Schulick; Barish Edil; Susannah Ellsworth; Timothy M Pawlik; Christine A Iacobuzio-Donahue; Ralph H Hruban; John L Cameron; Elliot K Fishman; Christopher L Wolfgang; Joseph M Herman Journal: J Radiat Oncol Date: 2013-09-22
Authors: Amanda J Walker; Sara R Alcorn; Amol K Narang; Katriana M Nugent; Aaron T Wild; Joseph M Herman; Phuoc T Tran Journal: Curr Probl Cancer Date: 2013-10-05 Impact factor: 3.187
Authors: Amanda B Cooper; Abhishek D Parmar; Taylor S Riall; Bruce L Hall; Matthew H G Katz; Thomas A Aloia; Henry A Pitt Journal: J Gastrointest Surg Date: 2014-08-05 Impact factor: 3.452