Distal pancreatectomy with
Distal pancreatectomy (DP)
celiac axis resection (CAR)
meta-analysis
modified appleby procedure
pancreatic neoplasm
Journal
Translational cancer research
ISSN: 2219-6803
Titre abrégé: Transl Cancer Res
Pays: China
ID NLM: 101585958
Informations de publication
Date de publication:
Nov 2020
Nov 2020
Historique:
received:
07
11
2019
accepted:
07
09
2020
entrez:
4
2
2022
pubmed:
1
11
2020
medline:
1
11
2020
Statut:
ppublish
Résumé
Pancreatic cancer frequently results in celiac artery invasion, resulting in an unresectable disease that generally has a median survival period of 6-11 months. Efforts to achieve curative resection of such tumors have been made by conducting distal pancreatectomy with This meta-analysis was conducted to systematically assess the clinical efficacy of the DP-CAR treatment of unresectable tumors of the pancreatic body or tail (registered with PROSPERO: CRD42019129612). The PubMed, EMBASE, the Cochrane Library, and Web of Science databases were searched to identify relevant retrospective studies pertaining to such treatment. Overall, 12 retrospective cohort analyses incorporating 213 total DP-CAR cases and 911 DP cases were incorporated into the present meta-analysis. Pooled analyses demonstrated that relative to DP, DP-CAR was related to a longer operative duration [mean difference (MD) -73.69, 95% confidence interval (CI): -112.99 to -34.38, P=0.0002] and higher blood transfusion rates [odds ratio (OR) 0.29, 95% CI: 0.10 to 0.87; P=0.03]. DP-CAR was also linked to increased rates of PV resection (OR 0.17, 95% CI: 0.07 to 0.39; P<0.001) and delayed gastric emptying (DGE) (OR 0.37, 95% CI: 0.15 to 0.93, P=0.03). In contrast, R0 resection rates were higher in the DP group (OR 2.79, 95% CI: 1.90 to 4.09, P<0.001), and these patients also had a significantly improved prognosis (median survival time, 27.0 This analysis indicates that DP-CAR is not an effective means of improving R0 rates. However, available studies suggest that it is nonetheless a potentially valuable treatment option for pancreatic cancer patients with celiac axis involvement, and it is associated with a reasonable median survival duration of 17.7 months.
Sections du résumé
BACKGROUND
BACKGROUND
Pancreatic cancer frequently results in celiac artery invasion, resulting in an unresectable disease that generally has a median survival period of 6-11 months. Efforts to achieve curative resection of such tumors have been made by conducting distal pancreatectomy with
METHODS
METHODS
This meta-analysis was conducted to systematically assess the clinical efficacy of the DP-CAR treatment of unresectable tumors of the pancreatic body or tail (registered with PROSPERO: CRD42019129612). The PubMed, EMBASE, the Cochrane Library, and Web of Science databases were searched to identify relevant retrospective studies pertaining to such treatment.
RESULTS
RESULTS
Overall, 12 retrospective cohort analyses incorporating 213 total DP-CAR cases and 911 DP cases were incorporated into the present meta-analysis. Pooled analyses demonstrated that relative to DP, DP-CAR was related to a longer operative duration [mean difference (MD) -73.69, 95% confidence interval (CI): -112.99 to -34.38, P=0.0002] and higher blood transfusion rates [odds ratio (OR) 0.29, 95% CI: 0.10 to 0.87; P=0.03]. DP-CAR was also linked to increased rates of PV resection (OR 0.17, 95% CI: 0.07 to 0.39; P<0.001) and delayed gastric emptying (DGE) (OR 0.37, 95% CI: 0.15 to 0.93, P=0.03). In contrast, R0 resection rates were higher in the DP group (OR 2.79, 95% CI: 1.90 to 4.09, P<0.001), and these patients also had a significantly improved prognosis (median survival time, 27.0
CONCLUSIONS
CONCLUSIONS
This analysis indicates that DP-CAR is not an effective means of improving R0 rates. However, available studies suggest that it is nonetheless a potentially valuable treatment option for pancreatic cancer patients with celiac axis involvement, and it is associated with a reasonable median survival duration of 17.7 months.
Identifiants
pubmed: 35117324
doi: 10.21037/tcr-19-2421
pii: tcr-09-11-7205
pmc: PMC8798231
doi:
Types de publication
Journal Article
Langues
eng
Pagination
7205-7213Informations de copyright
2020 Translational Cancer Research. All rights reserved.
Déclaration de conflit d'intérêts
Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/tcr-19-2421). The authors have no conflicts of interest to declare.
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