Systematic Review and Meta-Analysis of Clinical Outcomes after Enucleation of Pancreatic Metastases from Renal Cell Carcinoma.

IF 1.8 3区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Digestive Surgery Pub Date : 2023-01-01 DOI:10.1159/000528823

Stefania Brozzetti, Mariavittoria Carati, Antonio V Sterpetti

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引用次数: 0

Abstract

Introduction: A systematic review and meta-analysis of the literature was carried out to determine the clinical and oncological outcome of patients who had enucleation of solitary pancreatic metastases from renal cell carcinoma.

Methods: Operative mortality, postoperative complications, observed survival, and disease-free survival were analyzed. The clinical outcomes of patients who had enucleation were compared to those of 947 patients collected from the literature who had standard or atypical pancreatic resection for the same disease using propensity score matching.

Results: There was no postoperative mortality in the 56 patients who had enucleation of pancreatic metastases from renal cell carcinoma. In 51 patients, postoperative complications could be analyzed. Ten patients (10/51 = 19.6%) had postoperative complications. Three patients (3/51 = 5.9%) had major complications (Clavien-Dindo III or more). Five-year observed survival rates and disease-free survival for patients with enucleation were 92% and 79%, respectively. These results compared favorably with those obtained in patients who had standard resection and other forms of atypical resection (also using propensity score matching). Patients who had partial pancreatic resection (atypical or not) with pancreatic-jejunal anastomosis had increased rates of postoperative complications and local recurrences.

Conclusions: Enucleation of pancreatic metastases offers a valid solution in selected patients.

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肾细胞癌胰腺转移瘤去核后临床结果的系统评价和荟萃分析。

本研究对文献进行了系统回顾和荟萃分析，以确定肾细胞癌孤立性胰腺转移患者的临床和肿瘤学结果。方法:分析手术死亡率、术后并发症、观察生存率和无病生存率。将去核患者的临床结果与文献中收集的947例因同一疾病行标准或非典型胰腺切除术的患者的临床结果进行倾向评分匹配。结果:56例肾细胞癌胰腺转移瘤行去核手术，无术后死亡。对51例患者进行了术后并发症分析。术后并发症10例(10/51 = 19.6%)。3例(3/51 = 5.9%)出现严重并发症(Clavien-Dindo III及以上)。去核患者的5年观察生存率和无病生存率分别为92%和79%。这些结果与标准切除和其他形式的非典型切除(也使用倾向评分匹配)的患者所获得的结果进行了比较。胰部分切除术(非典型或非典型)合并胰空肠吻合术的患者术后并发症和局部复发率增加。结论:胰腺转移瘤去核治疗是一种有效的治疗方法。

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

Digestive Surgery 医学-外科

CiteScore

4.90

自引率

3.70%

发文量

审稿时长

3 months

期刊介绍： ''Digestive Surgery'' presents a comprehensive overview in the field of gastrointestinal surgery. Interdisciplinary in scope, the journal keeps the specialist aware of advances in all fields that contribute to improvements in the diagnosis and treatment of gastrointestinal disease. Particular emphasis is given to articles that evaluate not only recent clinical developments, especially clinical trials and technical innovations such as new endoscopic and laparoscopic procedures, but also relevant translational research. Each contribution is carefully aligned with the need of the digestive surgeon. Thus, the journal is an important component of the continuing medical education of surgeons who want their practice to benefit from a familiarity with new knowledge in all its dimensions.