INTRODUCTION: Metastases to the pancreas from other primary tumors are increasingly recognized in clinical practice, but the real role of surgery remains unclear. This study was designated to evaluate by a meta-analytic approach the results of surgical treatment for the most common malignancies metastasizing to the pancreas. EVIDENCE ACQUISITION: MEDLINE, PubMED, Scopus and Web of Sciences were searched from January 2000 to December 2015. Studies reporting postoperative complications, postoperative mortality, disease-free and overall survival of patients undergoing resection for secondary tumours of the pancreas, were included. EVIDENCE SYNTHESIS: Fourteen publication with 281 patients met the inclusion criteria and were subjected to the analysis. Operative morbidity and mortality were 34% and 1.3% respectively. Pancreatic resection for renal cell cancer showed better survival compared to other non-renal cell cancer (ratio of mean 1.83; 95% CI: 1.42-2.36, I2=74.52%, P<0.001). Disease-free interval was longer for metastatic renal cell carcinoma patients (mean difference 6.36, 95% CI: 3.803-8.912 years, I2=76:54%, P<0.001). A meta-regression was used to correlate the two endpoints and showed that a longer DFI is associated to a longer survival. CONCLUSIONS: Pancreatic resection for metastasis should be reserved to patients in good health conditions, with isolated disease from renal cell cancer. For other types of tumor, surgery should be performed only in individual basis. There is a need of studies evaluating the role of chemotherapy in the neoadjuvant setting or the best sequential use of multimodality treatment (targeted therapy, radiotherapy, surgery, etc.).
INTRODUCTION:Metastases to the pancreas from other primary tumors are increasingly recognized in clinical practice, but the real role of surgery remains unclear. This study was designated to evaluate by a meta-analytic approach the results of surgical treatment for the most common malignancies metastasizing to the pancreas. EVIDENCE ACQUISITION: MEDLINE, PubMED, Scopus and Web of Sciences were searched from January 2000 to December 2015. Studies reporting postoperative complications, postoperative mortality, disease-free and overall survival of patients undergoing resection for secondary tumours of the pancreas, were included. EVIDENCE SYNTHESIS: Fourteen publication with 281 patients met the inclusion criteria and were subjected to the analysis. Operative morbidity and mortality were 34% and 1.3% respectively. Pancreatic resection for renal cell cancer showed better survival compared to other non-renal cell cancer (ratio of mean 1.83; 95% CI: 1.42-2.36, I2=74.52%, P<0.001). Disease-free interval was longer for metastatic renal cell carcinomapatients (mean difference 6.36, 95% CI: 3.803-8.912 years, I2=76:54%, P<0.001). A meta-regression was used to correlate the two endpoints and showed that a longer DFI is associated to a longer survival. CONCLUSIONS: Pancreatic resection for metastasis should be reserved to patients in good health conditions, with isolated disease from renal cell cancer. For other types of tumor, surgery should be performed only in individual basis. There is a need of studies evaluating the role of chemotherapy in the neoadjuvant setting or the best sequential use of multimodality treatment (targeted therapy, radiotherapy, surgery, etc.).
Authors: Daniele Cignoli; Giuseppe Fallara; Francesca Aleotti; Alessandro Larcher; Giuseppe Rosiello; Isaline Rowe; Giuseppe Basile; Gianmarco Colandrea; Alberto Martini; Francesco De Cobelli; Giorgio Brembilla; Roberta Lucianò; Maurizio Colecchia; Marco Schiavo Lena; Stefano Partelli; Domenico Tamburrino; Giuseppe Zamboni; Corrado Rubini; Massimo Falconi; Francesco Montorsi; Andrea Salonia; Umberto Capitanio Journal: World J Urol Date: 2022-07-29 Impact factor: 3.661
Authors: Nirmish Singla; Zhiqun Xie; Ze Zhang; Ming Gao; Qurratulain Yousuf; Oreoluwa Onabolu; Tiffani McKenzie; Vanina Toffessi Tcheuyap; Yuanqing Ma; Jacob Choi; Renee McKay; Alana Christie; Oscar Reig Torras; Isaac A Bowman; Vitaly Margulis; Ivan Pedrosa; Christopher Przybycin; Tao Wang; Payal Kapur; Brian Rini; James Brugarolas Journal: JCI Insight Date: 2020-04-09
Authors: Mohamed A Abdallah; Kimberlee Bohy; Ashwani Singal; Chencheng Xie; Bhaveshkumar Patel; Morgan E Nelson; Jonathan Bleeker; Ryan Askeland; Ammar Abdullah; Khalil Aloreidi; Muslim Atiq Journal: Ann Hepatobiliary Pancreat Surg Date: 2022-02-28