Clinical effect of simultaneous surgical resection of hepatic and pancreatic lesions versus systemic chemotherapy in treatment of resectable pancreatic cancer with liver metastasis
10.3969/j.issn.1001-5256.2022.03.023
- VernacularTitle:肝胰同步手术切除与全身化疗治疗可切除胰腺癌伴肝转移患者的效果比较
- Author:
Tianqiang JIN
1
;
Chaoliu DAI
1
;
Feng XU
1
Author Information
1. Department of General Surgery, Shengjing Hospital of China Medical University, Shenyang 110004, China
- Publication Type:Original Articles_Pancreatic diseases
- Keywords:
Pancreatic Neoplasms;
Neoplasm Metastasis;
Surgical Procedures, Operative;
Antineoplastic Combined Chemotherapy Protocols;
Prognosis
- From:
Journal of Clinical Hepatology
2022;38(3):622-628
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinical effect of simultaneous surgical resection of hepatic and pancreatic lesions versus systemic chemotherapy in treatment of resectable pancreatic cancer with liver metastasis (PCLM). Methods A retrospective analysis was performed for related data of the patients with PCLM who were admitted to Shengjing Hospital of China Medical University from January 2013 to May 2020, and the patients with resectable PCLM were screened out and then divided into surgery group and chemotherapy group. The propensity score matching (PSM) method was used to reduce the impact of data bias and confounding factors. The independent samples t -test or the Mann- Whitney U test was used for comparison of continuous data between two groups, and the chi-square test was used for comparison of categorical data between two groups. The Kaplan-Meier method was used to calculate survival time, and the log-rank test was used for evaluation. The univariate and multivariate Cox regression models were used to investigate the independent risk factors for survival. Results A total of 56 patients with resectable PCLM were screened out, with 33 patients in the surgery group and 23 patients in the chemotherapy group, and there were 15 patients in each group after PSM. The surgery group had a significantly shorter median overall survival time than the chemotherapy group before PSM (6.6 months vs 10.4 months, χ 2 =4.476, P =0.034) and after PSM (6.4 months vs 10.5 months, χ 2 =4.309, P =0.038). The multivariate Cox regression analysis showed that poorly differentiated tumor (hazard ratio [ HR ]=4.945, 95% confidence interval [ CI ]: 1.980-12.348, P =0.001) and absence of postoperative chemotherapy ( HR =3.670, 95% CI : 1.437-9.376, P =0.007) were independent risk factors for poor prognosis in patients with PCLM. Conclusion Compared with chemotherapy, simultaneous surgical resection of hepatic and pancreatic lesions fails to prolong the overall survival time of patients with resectable PCLM. Patients with poorly differentiated tumor and those without postoperative chemotherapy tend to have poor prognosis.
