Ann Hepatobiliary Pancreat Surg.  2024 Aug;28(3):315-324. 10.14701/ahbps.24-041.

Meta-analysis of pancreatic re-resection for locally recurrent pancreatic cancer following index pancreatectomy

• Hajibandeh S
• Hajibandeh S
• Evans D
• Athwal TS

• KMID: 2558659
• DOI: http://doi.org/10.14701/ahbps.24-041

Abstract

The role of surgical resection in patients with recurrent pancreatic cancer is unclear. We aimed to evaluate the survival outcomes of pancreatic re-resection for locally recurrent pancreatic cancer following index pancreatectomy. A literature search was carried out in CENTRAL, EMBASE, MEDLINE, CINAHL, and Web of Science. Proportion meta-analysis model was constructed to quantify 1 to 5-year survival after pancreatic re-resection for locally recurrent pancreatic cancer. Random-effects modelling was applied to calculate pooled outcome data. Fifteen retrospective studies were included, reporting a total of 250 patients who underwent pancreatic re-resection for locally recurrent pancreatic cancer following their index pancreatectomy. Pancreatic re-resection was associated with 1-year survival 70.6% (95% confidence interval [CI], 65.0−76.2), 2-year survival 38.8% (95% CI, 28.6−49.0), 3-year survival 20.2% (95% CI, 13.8−26.7), and 5-year survival 9.2% (95% CI, 5.5−12.8). The between-study heterogeneity was insignificant in all outcome syntheses. Repeat pancreatectomy for local recurrence of pancreatic cancer in the remnant pancreas following the index pancreatectomy is associated with acceptable overall patient survival. We recommend selective re-resection of such recurrences in younger patients with favorable tumor size and location. Our findings may encourage more robust studies to be conducted in this context to provide stronger evidence.

Keyword

Pancreas cancer; Local recurrence; Re-resection; Survival

Figure

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  Fig. 1 PRISMA flow chart.

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  Fig. 2 Risk of bias summary and graph showing the authors’ judgments about each risk of the bias item.

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  Fig. 3 Forest plots for proportion meta-analysis of the survival outcomes after re-resection of the local recurrence of pancreatic cancer: (A) 1-year survival, (B) 2-year survival, (C) 3-year survival, and (D) 5-year survival. CI, confidence interval; Ev/Trt, event/treatment.

Reference

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