Simone Serafini1, Cosimo Sperti1, Alberto Friziero1, Alessandra Rosalba Brazzale2, Alessia Buratin3, Alberto Ponzoni4, Lucia Moletta1. 1. Department of Surgery, Oncology and Gastroenterology, 3rd Surgical Clinic, University of Padua, Via Giustiniani 2, 35128 Padua, Italy. 2. Department of Statistical Sciences, University of Padua, Via Cesare Battisti 241, 35121 Padua, Italy. 3. Department of Biology, University of Padua, Viale G. Colombo 3, 35131 Padua, Italy. 4. Department of Radiology, Padua General Hospital, Via Giustiniani 2, 35128 Padua, Italy.
Abstract
PURPOSE: To perform a systematic review and meta-analysis on the outcome of surgical treatment for isolated local recurrence of pancreatic cancer. METHODS: A systematic review and meta-analysis based on Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines was conducted in PubMed, Scopus, and Web of Science. RESULTS: Six studies concerning 431 patients with recurrent pancreatic cancer met the inclusion criteria and were included in the analysis: 176 underwent redo surgery, and 255 received non-surgical treatments. Overall survival and post-recurrence survival were significantly longer in the re-resected group (ratio of means (ROM) 1.99; 95% confidence interval (CI), 1.54-2.56, I2 = 75.89%, p = 0.006, and ROM = 2.05; 95% CI, 1.48-2.83, I2 = 76.39%, p = 0.002, respectively) with a median overall survival benefit of 28.7 months (mean difference (MD) 28.7; 95% CI, 10.3-47.0, I2 = 89.27%, p < 0.001) and median survival benefit of 15.2 months after re-resection (MD 15.2; 95% CI, 8.6-21.8, I2 = 58.22%, p = 0.048). CONCLUSION: Resection of isolated pancreatic cancer recurrences is safe and feasible and may offer a survival benefit. Selection of patients and assessment of time and site of recurrence are mandatory.
PURPOSE: To perform a systematic review and meta-analysis on the outcome of surgical treatment for isolated local recurrence of pancreatic cancer. METHODS: A systematic review and meta-analysis based on Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines was conducted in PubMed, Scopus, and Web of Science. RESULTS: Six studies concerning 431 patients with recurrent pancreatic cancer met the inclusion criteria and were included in the analysis: 176 underwent redo surgery, and 255 received non-surgical treatments. Overall survival and post-recurrence survival were significantly longer in the re-resected group (ratio of means (ROM) 1.99; 95% confidence interval (CI), 1.54-2.56, I2 = 75.89%, p = 0.006, and ROM = 2.05; 95% CI, 1.48-2.83, I2 = 76.39%, p = 0.002, respectively) with a median overall survival benefit of 28.7 months (mean difference (MD) 28.7; 95% CI, 10.3-47.0, I2 = 89.27%, p < 0.001) and median survival benefit of 15.2 months after re-resection (MD 15.2; 95% CI, 8.6-21.8, I2 = 58.22%, p = 0.048). CONCLUSION: Resection of isolated pancreatic cancer recurrences is safe and feasible and may offer a survival benefit. Selection of patients and assessment of time and site of recurrence are mandatory.
Entities:
Keywords:
isolated local recurrence; pancreatectomy; pancreatic cancer; pancreatic remnant; recurrence; redo surgery