Journal
INTERNATIONAL JOURNAL OF SURGERY
Volume 48, Issue -, Pages 149-154Publisher
ELSEVIER SCIENCE BV
DOI: 10.1016/j.ijsu.2017.10.066
Keywords
Pancreatic ductal adenocarcinoma; Liver metastases; Metastasectomy; Hepatectomy; Meta-analysis
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Funding
- National Natural Science Foundation of China [81472221]
- Key Project of National Health and Planning Commission of the PRC on General Surgery
- Key Project of National Health and Planning Commission of the PRC on Oncology
- Research Fund for the Doctoral Program of Higher Education of China [20130071110052, 20110071110065]
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Objective: The objectives of this systematic review and meta-analysis were to examine morbidity, mortality, and long-term survival after surgical resection of hepatic metastases from pancreatic ductal adenocarcinoma (PDAC) patients. Background: Patients with hepatic metastases from pancreatic ductal adenocarcinoma are facing a dilemma of whether to make hepatic resection. Methods: A systematic literature research was undertaken through computerized databases as well as manually research from unpublished data. A meta-analysis was performed to investigate the differences in the efficacy of liver resection and non-surgical treatments based on the evaluation of morbidity, 30-day mortality, and 1-, 3-, or 5-year survival. Results: 11 cohort studies with 1147 patients were identified in the pool. Compared with the non-surgical approach, hepatic resection can be performed in a safe and feasible manner for all pancreatic cancer patients with liver metastases (p = 0.13 for overall morbidity; p = 0.63 for mortality). For surgical group, the median 1-year, 3-year, and 5-year survival were 40.9%, 13.3%, 2.9%, respectively, with a median survival of 9.9 months. Surgical resection of hepatic metastases was associated with a significantly improved overall 1-year and 3-year survival (p < 0.001). Conclusions: Hepatic resection is a safe procedure; furthermore, it is worth doing such an extended surgery for PDAC patients due to additional survival benefit in the medium-term (less than 3 years). However, further randomized, controlled trials are urgently needed.
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