Ke Chen1,2, Yucheng Zhou1,2, Weiwei Jin1, Qicong Zhu1, Chao Lu1, Nan Niu1, Yuanyu Wang1, Yiping Mou3,4, Zheling Chen5,6. 1. Department of Gastroenterology & Pancreatic Surgery, Zhejiang Province People's Hospital, No 158 Shangtang Road, Hangzhou, 310000, Zhejiang, People's Republic of China. 2. Key Laboratory of Gastroenterology of Zhejiang Province, Hangzhou, 310014, Zhejiang, People's Republic of China. 3. Department of Gastroenterology & Pancreatic Surgery, Zhejiang Province People's Hospital, No 158 Shangtang Road, Hangzhou, 310000, Zhejiang, People's Republic of China. yippingmou@126.com. 4. Key Laboratory of Gastroenterology of Zhejiang Province, Hangzhou, 310014, Zhejiang, People's Republic of China. yippingmou@126.com. 5. Department of Medical Oncology, Zhejiang Province People's Hospital, No.158 Shangtang Road, Hangzhou, 310000, Zhejiang, People's Republic of China. 383974903@qq.com. 6. Key Laboratory of Gastroenterology of Zhejiang Province, Hangzhou, 310014, Zhejiang, People's Republic of China. 383974903@qq.com.
Abstract
OBJECTIVE: The study aimed to compare the oncologic outcomes and long-term survival of laparoscopic pancreaticoduodenectomy (LPD) and open pancreaticoduodenectomy (OPD) for patients diagnosed with pancreatic ductal adenocarcinoma (PDAC). BACKGROUND: Substantial evidence demonstrated that LPD is technically safe and feasible with perioperative outcomes equivalent to that of OPD. However, for patients with malignancy, especially PDAC, the oncologic outcomes and long-term survival of patients who underwent LPD remains to be elucidated. METHODS: Studies on LPD for the treatment of PDAC published before December 25, 2018 were searched online. The oncologic outcomes (e.g., numbers of lymph nodes retrieved, negative margin (R0) resection), and long-term survival (postoperative survival from 1 to 5 year) of LPD were compared to that of ODP. RESULTS: After screening 1507 studies, six comparative cohort studies, which reported the oncologic outcomes and long-term survival of patients with PDAC were included. No significant difference was found between LPD and OPD regarding lymph nodes harvested (OR 1.96, 95% CI - 1.17 to 5.09, p = 0.22), R0 rate (OR 1.44, 95% CI 1.00 to 2.06, p = 0.05), number of positive lymph nodes (OR - 0.44, 95% CI - 1.06 to 0.17, p = 0.16), rate of adjuvant treatment (OR 1.04, 95% CI 0.68 to 1.59, p = 0.86) and time to adjuvant treatment (OR - 6.21, 95% CI - 16.00 to 3.59, p = 0.21). LPD showed similar 1-year (OR 1.20, 95% CI 0.87 to 1.65, p = 0.28), and 2-year survival (OR 1.25, 95% CI 0.94 to 1.66, p = 0.13) to that of OPD. The 3-year (OR 1.50, 95% CI 1.12 to 2.02, p = 0.007), 4-year (OR 1.73, 95% CI 1.02 to 2.93, p = 0.04), and 5-year survival (OR 2.11, 95% CI 1.35 to 3.31, p = 0.001) were significantly longer in LPD group. CONCLUSION: For the treatment of PDAC, the oncologic outcomes of LPD were equivalent to that of OPD; LPD seemed promising regarding the postoperative long-term survival.
OBJECTIVE: The study aimed to compare the oncologic outcomes and long-term survival of laparoscopic pancreaticoduodenectomy (LPD) and open pancreaticoduodenectomy (OPD) for patients diagnosed with pancreatic ductal adenocarcinoma (PDAC). BACKGROUND: Substantial evidence demonstrated that LPD is technically safe and feasible with perioperative outcomes equivalent to that of OPD. However, for patients with malignancy, especially PDAC, the oncologic outcomes and long-term survival of patients who underwent LPD remains to be elucidated. METHODS: Studies on LPD for the treatment of PDAC published before December 25, 2018 were searched online. The oncologic outcomes (e.g., numbers of lymph nodes retrieved, negative margin (R0) resection), and long-term survival (postoperative survival from 1 to 5 year) of LPD were compared to that of ODP. RESULTS: After screening 1507 studies, six comparative cohort studies, which reported the oncologic outcomes and long-term survival of patients with PDAC were included. No significant difference was found between LPD and OPD regarding lymph nodes harvested (OR 1.96, 95% CI - 1.17 to 5.09, p = 0.22), R0 rate (OR 1.44, 95% CI 1.00 to 2.06, p = 0.05), number of positive lymph nodes (OR - 0.44, 95% CI - 1.06 to 0.17, p = 0.16), rate of adjuvant treatment (OR 1.04, 95% CI 0.68 to 1.59, p = 0.86) and time to adjuvant treatment (OR - 6.21, 95% CI - 16.00 to 3.59, p = 0.21). LPD showed similar 1-year (OR 1.20, 95% CI 0.87 to 1.65, p = 0.28), and 2-year survival (OR 1.25, 95% CI 0.94 to 1.66, p = 0.13) to that of OPD. The 3-year (OR 1.50, 95% CI 1.12 to 2.02, p = 0.007), 4-year (OR 1.73, 95% CI 1.02 to 2.93, p = 0.04), and 5-year survival (OR 2.11, 95% CI 1.35 to 3.31, p = 0.001) were significantly longer in LPD group. CONCLUSION: For the treatment of PDAC, the oncologic outcomes of LPD were equivalent to that of OPD; LPD seemed promising regarding the postoperative long-term survival.
Entities:
Keywords:
Laparoscopic pancreaticoduodenectomy; Long-term survival; Meta-analysis; Oncologic outcomes; Pancreatic cancer
Authors: Olga Kantor; Mark S Talamonti; Susan Sharpe; Waseem Lutfi; David J Winchester; Kevin K Roggin; David J Bentrem; Richard A Prinz; Marshall S Baker Journal: Am J Surg Date: 2016-12-28 Impact factor: 2.565
Authors: Lola Rahib; Benjamin D Smith; Rhonda Aizenberg; Allison B Rosenzweig; Julie M Fleshman; Lynn M Matrisian Journal: Cancer Res Date: 2014-06-01 Impact factor: 12.701
Authors: Jorg Kleeff; Murray Korc; Minoti Apte; Carlo La Vecchia; Colin D Johnson; Andrew V Biankin; Rachel E Neale; Margaret Tempero; David A Tuveson; Ralph H Hruban; John P Neoptolemos Journal: Nat Rev Dis Primers Date: 2016-04-21 Impact factor: 52.329
Authors: Simon Kuesters; Sophia Chikhladze; Frank Makowiec; Olivia Sick; Stefan Fichtner-Feigl; Ulrich T Hopt; Uwe A Wittel Journal: Int J Surg Date: 2018-05-25 Impact factor: 6.071
Authors: Daniel Delitto; Casey M Luckhurst; Brian S Black; John L Beck; Thomas J George; George A Sarosi; Ryan M Thomas; Jose G Trevino; Kevin E Behrns; Steven J Hughes Journal: J Gastrointest Surg Date: 2016-05-03 Impact factor: 3.452
Authors: Pedro T Ramirez; Michael Frumovitz; Rene Pareja; Aldo Lopez; Marcelo Vieira; Reitan Ribeiro; Alessandro Buda; Xiaojian Yan; Yao Shuzhong; Naven Chetty; David Isla; Mariano Tamura; Tao Zhu; Kristy P Robledo; Val Gebski; Rebecca Asher; Vanessa Behan; James L Nicklin; Robert L Coleman; Andreas Obermair Journal: N Engl J Med Date: 2018-10-31 Impact factor: 91.245