Radical resection benefits patients suffering pancreatic ductal adenocarcinoma with liver oligometastases.

IF 1.2 4区医学 Q3 SURGERY

Annals of Surgical Treatment and Research Pub Date : 2024-01-01 Epub Date: 2023-12-28 DOI:10.4174/astr.2024.106.1.51

Qingyan Kong, Fei Teng, Hang Li, Zheyu Chen

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引用次数: 0

Abstract

Purpose: Whether patients suffering liver oligometastases from pancreatic ductal adenocarcinoma (LOPDA) should undergo surgical treatment remains controversial.

Methods: PubMed and Embase databases were systematically reviewed until 2023 June. Survival data were collected from the Kaplan-Meier curves. Safety and survival were evaluated using primary outcomes such as 1-year, 3-year, and 5-year survival rates, and 30-day mortality and morbidity. A subgroup meta-analysis was conducted to compare survival rates post-synchronous resection and resection post-neoadjuvant chemotherapy in LOPDA.

Results: Our analysis of 15 studies involving 1,818 patients (surgical group, 648 and nonsurgical group, 1,170) indicates that radical hepatectomy for LOPDA notably improved 1-year (odds ratio [OR], 3.24; 95% confidence interval [CI], 2.45-4.28; P < 0.001), 3-year (OR, 5.74; 95% CI, 3.36-8.90; P < 0.001), and 5-year (OR, 4.89; 95% CI, 2.56-9.35; P < 0.001) overall survival (OS) rates. A separate analysis of 6 studies with 750 patients demonstrated the safety of LOPDA surgery, with no increase in postoperative complications (P = 0.26 for overall morbidity and P = 0.99 for mortality) compared to the patients with no metastatic disease from the pancreatic ductal adenocarcinoma (NMPDA) group. The NMPDA group showed superior 1-year and 3-year OS rates, but not 5-year OS rates compared to the LOPDA group.

Conclusion: Surgical treatment apparently offers a survival advantage to LOPDA by comparing with nonsurgical groups in 1-, 3-, and 5-year OS rates. Radical resection for LOPDA is a safe treatment without more postoperative complications than NMPDA.

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根治性切除术有益于伴有肝脏寡转移的胰腺导管腺癌患者。

目的：胰腺导管腺癌（LOPDA）肝寡转移患者是否应接受手术治疗仍存在争议：方法：系统回顾了截至 2023 年 6 月的 PubMed 和 Embase 数据库。通过卡普兰-梅耶曲线收集生存数据。使用 1 年、3 年和 5 年存活率、30 天死亡率和发病率等主要结果评估安全性和存活率。我们还进行了一项亚组荟萃分析，以比较 LOPDA 同步切除术后和新辅助化疗后的生存率：我们对涉及1,818例患者（手术组648例，非手术组1,170例）的15项研究进行了分析，结果表明LOPDA根治性肝切除术显著提高了1年生存率（几率比[OR]，3.24；95% 置信区间 [CI]，2.45-4.28；P <0.001）、3 年（OR，5.74；95% CI，3.36-8.90；P <0.001）和 5 年（OR，4.89；95% CI，2.56-9.35；P <0.001）总生存率 (OS)。对6项研究中的750名患者进行的单独分析表明，LOPDA手术是安全的，与胰腺导管腺癌（NMPDA）组没有转移性疾病的患者相比，术后并发症没有增加（总发病率P = 0.26，死亡率P = 0.99）。NMPDA组的1年和3年生存率高于LOPDA组，但5年生存率低于LOPDA组：结论：与非手术组相比，手术治疗在 LOPDA 的 1 年、3 年和 5 年 OS 率方面明显具有生存优势。LOPDA根治性切除术是一种安全的治疗方法，术后并发症少于NMPDA。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annals of Surgical Treatment and Research SURGERY-

CiteScore

2.30

自引率

7.10%

发文量

期刊介绍： Manuscripts to the Annals of Surgical Treatment and Research (Ann Surg Treat Res) should be written in English according to the instructions for authors. If the details are not described below, the style should follow the Uniform Requirements for Manuscripts Submitted to Biomedical Journals: Writing and Editing for Biomedical Publications available at International Committee of Medical Journal Editors (ICMJE) website (http://www.icmje.org).