{"title":"转移性胰腺腺癌有治愈性治疗的机会吗？荟萃分析的系统综述。","authors":"Kellil Tarek, Tormane Mohamed Amine, Rhaiem Rami, Amara Amal, Gianpaoli Francesca, Sanchez Stephane, Piardi Tullio","doi":"10.1007/s00423-025-03778-6","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Pancreatic adenocarcinomas (PDAC) have a poor prognosis, with a 5-year relative Survival rate of 11.5%. Only 20% of patients are initially eligible for resection, and 50% of patients presented with metastatic disease, currently only candidates' palliative treatment. This meta-analysis compares the outcomes of surgical treatment versus chemotherapy or palliative care for M-PDAC.</p><p><strong>Methods: </strong>A literature search was performed on May, 9th of 2024. A meta-analysis was then conducted. The primary outcome was Overall Survival and the secondary outcomes were 1-year Survival and 3-year survival. Subgroup analysis was also performed, based on metastatic sites.</p><p><strong>Results: </strong>The analyses showed a significant benefit of surgical treatment in terms of overall survival (HR: 0.42, 95% CI [0.33- 0.53]), 1-year survival (OR: 0.37, CI 95% [0.26, 0.52]), and 3-year survival (OR: 0.16, CI 95% [0.07, 0.383]). In the subgroup analysis based on metastatic site, the benefit of surgical treatment persisted for liver-only metastases (HR : 0.40, CI 95% [0.29, 0.53]), but not for lung-only metastases.</p><p><strong>Conclusion: </strong>This meta-analysis showed a survival advantage for surgical treatment in patients with M-PDAC and especially in liver-only metastases. Prospective trials are needed to confirm these findings and refine patient selection criteria for surgical treatment.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"269"},"PeriodicalIF":1.8000,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12423236/pdf/","citationCount":"0","resultStr":"{\"title\":\"Is there a chance for curative treatment for metastatic pancreatic adenocarcinoma? A systematic review with meta-analysis.\",\"authors\":\"Kellil Tarek, Tormane Mohamed Amine, Rhaiem Rami, Amara Amal, Gianpaoli Francesca, Sanchez Stephane, Piardi Tullio\",\"doi\":\"10.1007/s00423-025-03778-6\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Pancreatic adenocarcinomas (PDAC) have a poor prognosis, with a 5-year relative Survival rate of 11.5%. Only 20% of patients are initially eligible for resection, and 50% of patients presented with metastatic disease, currently only candidates' palliative treatment. This meta-analysis compares the outcomes of surgical treatment versus chemotherapy or palliative care for M-PDAC.</p><p><strong>Methods: </strong>A literature search was performed on May, 9th of 2024. A meta-analysis was then conducted. The primary outcome was Overall Survival and the secondary outcomes were 1-year Survival and 3-year survival. Subgroup analysis was also performed, based on metastatic sites.</p><p><strong>Results: </strong>The analyses showed a significant benefit of surgical treatment in terms of overall survival (HR: 0.42, 95% CI [0.33- 0.53]), 1-year survival (OR: 0.37, CI 95% [0.26, 0.52]), and 3-year survival (OR: 0.16, CI 95% [0.07, 0.383]). In the subgroup analysis based on metastatic site, the benefit of surgical treatment persisted for liver-only metastases (HR : 0.40, CI 95% [0.29, 0.53]), but not for lung-only metastases.</p><p><strong>Conclusion: </strong>This meta-analysis showed a survival advantage for surgical treatment in patients with M-PDAC and especially in liver-only metastases. Prospective trials are needed to confirm these findings and refine patient selection criteria for surgical treatment.</p>\",\"PeriodicalId\":17983,\"journal\":{\"name\":\"Langenbeck's Archives of Surgery\",\"volume\":\"410 1\",\"pages\":\"269\"},\"PeriodicalIF\":1.8000,\"publicationDate\":\"2025-09-10\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12423236/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Langenbeck's Archives of Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s00423-025-03778-6\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Langenbeck's Archives of Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00423-025-03778-6","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0
摘要
胰腺腺癌（PDAC）预后较差，5年相对生存率为11.5%。只有20%的患者最初符合切除条件，50%的患者出现转移性疾病，目前只有候选的姑息治疗。本荟萃分析比较了M-PDAC的手术治疗与化疗或姑息治疗的结果。方法：于2024年5月9日进行文献检索。然后进行meta分析。主要终点是总生存期，次要终点是1年生存期和3年生存期。根据转移部位进行亚组分析。结果：分析显示手术治疗在总生存率（HR: 0.42, 95% CI[0.33- 0.53]）、1年生存率（OR: 0.37, CI 95%[0.26, 0.52]）和3年生存率（OR: 0.16, CI 95%[0.07, 0.383]）方面有显著的益处。在基于转移部位的亚组分析中，手术治疗对仅肝转移的益处持续存在（HR: 0.40, CI 95%[0.29, 0.53]），但对仅肺转移的益处不存在。结论：该荟萃分析显示，手术治疗M-PDAC患者，特别是仅肝转移患者的生存优势。需要前瞻性试验来证实这些发现并完善手术治疗的患者选择标准。
Is there a chance for curative treatment for metastatic pancreatic adenocarcinoma? A systematic review with meta-analysis.
Introduction: Pancreatic adenocarcinomas (PDAC) have a poor prognosis, with a 5-year relative Survival rate of 11.5%. Only 20% of patients are initially eligible for resection, and 50% of patients presented with metastatic disease, currently only candidates' palliative treatment. This meta-analysis compares the outcomes of surgical treatment versus chemotherapy or palliative care for M-PDAC.
Methods: A literature search was performed on May, 9th of 2024. A meta-analysis was then conducted. The primary outcome was Overall Survival and the secondary outcomes were 1-year Survival and 3-year survival. Subgroup analysis was also performed, based on metastatic sites.
Results: The analyses showed a significant benefit of surgical treatment in terms of overall survival (HR: 0.42, 95% CI [0.33- 0.53]), 1-year survival (OR: 0.37, CI 95% [0.26, 0.52]), and 3-year survival (OR: 0.16, CI 95% [0.07, 0.383]). In the subgroup analysis based on metastatic site, the benefit of surgical treatment persisted for liver-only metastases (HR : 0.40, CI 95% [0.29, 0.53]), but not for lung-only metastases.
Conclusion: This meta-analysis showed a survival advantage for surgical treatment in patients with M-PDAC and especially in liver-only metastases. Prospective trials are needed to confirm these findings and refine patient selection criteria for surgical treatment.
期刊介绍：
Langenbeck''s Archives of Surgery aims to publish the best results in the field of clinical surgery and basic surgical research. The main focus is on providing the highest level of clinical research and clinically relevant basic research. The journal, published exclusively in English, will provide an international discussion forum for the controlled results of clinical surgery. The majority of published contributions will be original articles reporting on clinical data from general and visceral surgery, while endocrine surgery will also be covered. Papers on basic surgical principles from the fields of traumatology, vascular and thoracic surgery are also welcome. Evidence-based medicine is an important criterion for the acceptance of papers.
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