Liver resection for patients with liver metastasis of pancreatic neuroendocrine tumors: a meta-analysis
10.3760/cma.j.issn.1674-6090.2013.05.023
- VernacularTitle:手术切除治疗胰腺神经内分泌肿瘤肝转移的Meta分析
- Author:
Jun YANG
;
Guangwen ZHOU
- Publication Type:Journal Article
- Keywords:
Pancreatic neuroendocrine tumours;
Liver metastasis;
Surgery;
Survival rates;
Meta analysis
- From:
Journal of Endocrine Surgery
2013;7(5):418-423
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the potential benefits of liver resection for patients with liver metastasis of pancreatic neuroendocrine tumors(PNETs).Methods We searched CNKI,CBM,MEDLINE,The Cochrane Library,EMBASE until Aug.2012 for identifying randomized trials.Randomized clinical trials(irrespective of language,blinding,or publication status)were collected to compare liver resection alone versus other unresected interventions(radiofrequency ablation,chemotherapy,hepatic arterial embolization,or drugs et al)in patients with liver metastasis from PNETs.Two authors independently identified trials for inclusion.The primary outcome was survival,treatment-related mortality(30-day mortality)and relief of symptoms.RevMan 5.1 software was used for Meta analysis.Results There was no meta-anlaysis,RCT,QRCT showing the clinical effect of operation for the treatment of pancreatic neuroendocrine tumor with liver metastasis.Only 6 cohort studies found were eligible and analyzed,involving 1020 patients.Compared with unresected treatment,the 3-year survival rate[OR =0.24,95％ CI (0.11,0.53),P =0.0004],the 5-year survival rate [OR =0.16,95 ％ CI (0.12,0.22),P ＜ 0.00001] and median survival time (109.5 ± 19.02 vs 31.2 ± 5.97 months,P ＜ 0.01) were significantly increased in liver resection alone.The symptom relief rate was substantially higher in the surgical group than in the non-surgical group(98.3 ±2.8 vs 62.5 ± 22.0,P ＜ 0.05).Perioperative mortality rate was lower in surgical group.Conclusions Surgical resection is the preferred treatment of PNETs in patients with liver metastasis.Surgery is safe and effective.Survival time is significantly extended and symptom relief rate significantly improves.Due to lack of randomized controlled trial (RCT),surgical resection for treatment of liver metastasis of PNETs requires further more randomized control study.
