Abstract:
The role of surgical resection in patients with recurrent pancreatic cancer is unclear. We aimed to evaluate the survival outcomes of pancreatic re-resection for locally recurrent pancreatic cancer following index pancreatectomy. A literature search was carried out in CENTRAL, EMBASE, MEDLINE, CINAHL, and Web of Science. Proportion meta-analysis model was constructed to quantify 1 to 5-year survival after pancreatic re-resection for locally recurrent pancreatic cancer. Random-effects modelling was applied to calculate pooled outcome data. Fifteen retrospective studies were included, reporting a total of 250 patients who underwent pancreatic re-resection for locally recurrent pancreatic cancer following their index pancreatectomy. Pancreatic re-resection was associated with 1-year survival 70.6% (95% confidence interval [CI], 65.0-76.2), 2-year survival 38.8% (95% CI, 28.6-49.0), 3-year survival 20.2% (95% CI, 13.8-26.7), and 5-year survival 9.2% (95% CI, 5.5-12.8). The between-study heterogeneity was insignificant in all outcome syntheses. Repeat pancreatectomy for local recurrence of pancreatic cancer in the remnant pancreas following the index pancreatectomy is associated with acceptable overall patient survival. We recommend selective re-resection of such recurrences in younger patients with favorable tumor size and location. Our findings may encourage more robust studies to be conducted in this context to provide stronger evidence.
摘要:
手术切除在复发性胰腺癌患者中的作用尚不清楚。我们旨在评估索引胰腺切除术后胰腺再次切除术对局部复发性胰腺癌的生存结果。在CENTRAL进行了文献检索,EMBASE,MEDLINE,CINAHL,和WebofScience。建立比例荟萃分析模型,以量化局部复发胰腺癌再次切除后1至5年的生存率。随机效应模型用于计算合并结果数据。包括15项回顾性研究,报告共有250例患者在初次胰腺切除术后因局部复发性胰腺癌接受了胰腺再切除术.胰腺再切除与1年生存率相关70.6%(95%置信区间[CI],65.0-76.2),2年生存率38.8%(95%CI,28.6-49.0),3年生存率20.2%(95%CI,13.8-26.7),5年生存率为9.2%(95%CI,5.5-12.8)。在所有结果综合中,研究之间的异质性均不显著。初次胰腺切除术后残余胰腺局部复发的重复胰腺切除术与可接受的总体患者生存率相关。我们建议在肿瘤大小和位置良好的年轻患者中选择性再切除此类复发。我们的发现可能会鼓励在这种情况下进行更有力的研究,以提供更有力的证据。