Radical resection benefits patients suffering pancreatic ductal adenocarcinoma with liver oligometastases
10.4174/astr.2024.106.1.51
- Author:
Qingyan KONG
1
;
Fei TENG
;
Hang LI
;
Zheyu CHEN
Author Information
1. Division of Hepatic Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China
- Publication Type:ORIGINAL ARTICLE
- From:Annals of Surgical Treatment and Research
2024;106(1):51-60
- CountryRepublic of Korea
- Language:EN
-
Abstract:
Purpose:Whether patients suffering liver oligometastases from pancreatic ductal adenocarcinoma (LOPDA) should undergo surgical treatment remains controversial.
Methods:PubMed and Embase databases were systematically reviewed until 2023 June. Survival data were collected from the Kaplan-Meier curves. Safety and survival were evaluated using primary outcomes such as 1-year, 3-year, and 5-year survival rates, and 30-day mortality and morbidity. A subgroup meta-analysis was conducted to compare survival rates post-synchronous resection and resection post-neoadjuvant chemotherapy in LOPDA.
Results:Our analysis of 15 studies involving 1,818 patients (surgical group, 648 and nonsurgical group, 1,170) indicates that radical hepatectomy for LOPDA notably improved 1-year (odds ratio [OR], 3.24; 95% confidence interval [CI], 2.45–4.28; P < 0.001), 3-year (OR, 5.74; 95% CI, 3.36–8.90; P < 0.001), and 5-year (OR, 4.89; 95% CI, 2.56–9.35; P < 0.001) overall survival (OS) rates. A separate analysis of 6 studies with 750 patients demonstrated the safety of LOPDA surgery, with no increase in postoperative complications (P = 0.26 for overall morbidity and P = 0.99 for mortality) compared to the patients with no metastatic disease from the pancreatic ductal adenocarcinoma (NMPDA) group. The NMPDA group showed superior 1-year and 3-year OS rates, but not 5-year OS rates compared to the LOPDA group.
Conclusion:Surgical treatment apparently offers a survival advantage to LOPDA by comparing with nonsurgical groups in 1-, 3-, and 5-year OS rates. Radical resection for LOPDA is a safe treatment without more postoperative complications than NMPDA.
