Dose surgical resection of hepatic metastases bring benefits to pancreatic ductal adenocarcinoma? A systematic review and meta-analysis. (December 2017)

• Record Type: Journal Article
• Authors: Yu, Xinzhe; Gu, Jichun; Fu, Deliang; Jin, Chen
• Is Part Of: International journal of surgery. Volume 48(2017)
• Page Start: 149
• Page End: 154
• Publication Date: 2017-12
• Subjects: Pancreatic ductal adenocarcinoma -- Liver metastases -- Metastasectomy -- Hepatectomy -- Meta-analysis; Surgery -- Periodicals; Surgical Procedures, Operative -- Periodicals; 617.005
• DOI: 10.1016/j.ijsu.2017.10.066
• Languages: English
• ISSNs: 1743-9191

Abstract

Abstract: 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A systematic literature research was undertaken through computerized databases as well as manually research from unpublished data.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. Highlights: Liver metastasis is challenging, the optimal therapeutic way remains controversial. Surgical resection of hepatic metastases was associated with improved overall 1-year and 3-year survival ( p < 0.001). The first systematic review and meta-analysis regards to hepatic resection benefit for PDAC patients with liver metastasis.