Xinzhe Yu1, Jichun Gu1, Deliang Fu1, Chen Jin2. 1. Pancreatic Surgery Department, Huashan Hospital Affiliated to Fudan University, PR China. 2. Pancreatic Surgery Department, Huashan Hospital Affiliated to Fudan University, PR China. Electronic address: galleyking@hotmail.com.
Abstract
OBJECTIVE: The objectives of this systematic review and meta-analysis were to examine morbidity, mortality, and long-term survival after surgical resection of hepatic metastases from pancreatic ductal adenocarcinoma (PDAC) patients. BACKGROUND: Patients with hepatic metastases from pancreatic ductal adenocarcinoma are facing a dilemma of whether to make hepatic resection. METHODS: A systematic literature research was undertaken through computerized databases as well as manually research from unpublished data. A meta-analysis was performed to investigate the differences in the efficacy of liver resection and non-surgical treatments based on the evaluation of morbidity, 30-day mortality, and 1-, 3-, or 5-year survival. RESULTS: 11 cohort studies with 1147 patients were identified in the pool. Compared with the non-surgical approach, hepatic resection can be performed in a safe and feasible manner for all pancreatic cancer patients with liver metastases (p = 0.13 for overall morbidity; p = 0.63 for mortality). For surgical group, the median 1-year, 3-year, and 5-year survival were 40.9%, 13.3%, 2.9%, respectively, with a median survival of 9.9 months. Surgical resection of hepatic metastases was associated with a significantly improved overall 1-year and 3-year survival (p < 0.001). CONCLUSIONS: Hepatic resection is a safe procedure; furthermore, it is worth doing such an extended surgery for PDAC patients due to additional survival benefit in the medium-term (less than 3 years). However, further randomized, controlled trials are urgently needed.
OBJECTIVE: The objectives of this systematic review and meta-analysis were to examine morbidity, mortality, and long-term survival after surgical resection of hepatic metastases from pancreatic ductal adenocarcinoma (PDAC) patients. BACKGROUND:Patients with hepatic metastases from pancreatic ductal adenocarcinoma are facing a dilemma of whether to make hepatic resection. METHODS: A systematic literature research was undertaken through computerized databases as well as manually research from unpublished data. A meta-analysis was performed to investigate the differences in the efficacy of liver resection and non-surgical treatments based on the evaluation of morbidity, 30-day mortality, and 1-, 3-, or 5-year survival. RESULTS: 11 cohort studies with 1147 patients were identified in the pool. Compared with the non-surgical approach, hepatic resection can be performed in a safe and feasible manner for all pancreatic cancerpatients with liver metastases (p = 0.13 for overall morbidity; p = 0.63 for mortality). For surgical group, the median 1-year, 3-year, and 5-year survival were 40.9%, 13.3%, 2.9%, respectively, with a median survival of 9.9 months. Surgical resection of hepatic metastases was associated with a significantly improved overall 1-year and 3-year survival (p < 0.001). CONCLUSIONS:Hepatic resection is a safe procedure; furthermore, it is worth doing such an extended surgery for PDACpatients due to additional survival benefit in the medium-term (less than 3 years). However, further randomized, controlled trials are urgently needed.
Authors: Natasha Leigh; Daniel Solomon; Eric Pletcher; Daniel M Labow; Deepa R Magge; Umut Sarpel; Benjamin J Golas Journal: World J Surg Oncol Date: 2020-06-11 Impact factor: 2.754
Authors: E Martin-Perez; J E Domínguez-Muñoz; F Botella-Romero; L Cerezo; F Matute Teresa; T Serrano; R Vera Journal: Clin Transl Oncol Date: 2020-04-21 Impact factor: 3.405
Authors: D M Filippini; E Grassi; A Palloni; R Carloni; R Casadei; C Ricci; C Serra; G Ercolani; G Brandi; M Di Marco Journal: BMC Cancer Date: 2020-03-30 Impact factor: 4.430