Feasibility of pancreaticoduodenectomy with synchronous liver metastasectomy for oligometastatic pancreatic ductal adenocarcinoma - A case-control study.
Feasibility of pancreaticoduodenectomy with synchronous liver metastasectomy for oligometastatic pancreatic ductal adenocarcinoma - A case-control study.
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胰十二指肠切除术同步肝转移瘤切除术治疗寡转移性胰腺导管腺癌的可行性——病例对照研究
DOI：
10.1016/j.amsu.2020.11.037
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发表时间：
2021-03
期刊：
影响因子：
--
通讯作者：
Zheng S
中科院分区：
文献类型：
--
作者：
Shao Y;Feng J;Hu Z;Wu J;Zhang M;Shen Y;Zheng S
胰导管腺癌（PDAC）的切除与同步肝转移切除术仍然是一个有争议的问题。我们的目的是评估在一个大容量的外科中心同步切除PDAC和肝转移的可行性。行胰十二指肠切除术（PD）合并肝转移瘤切除术的患者（M1切除组，n = 50）根据肿瘤及结节分期、年龄、性别、体重指数及伴发疾病与对照组（M0切除和M1未切除）1∶1配对。M0切除组包括未发生转移的PD患者。M1不切除组包括肝转移患者，行姑息性旁路或探查性剖腹手术，不切除，然后姑息性和辅助治疗。与其他两组相比，M1切除组手术时间更长，术中出血量较大，术后住院时间更长。M1切除组的R0切除率与M0切除组相似（92% vs. 94%, p = 1.000）。两组间术后并发症具有可比性。M1切除组、M0切除组和M1不切除组的总中位生存期分别为16个月、30个月和6个月。M1切除组、M0切除组和M1未切除组的1年、2年和3年累积生存率分别为63.8%、29.0%和6.7%；94.0%、74.4%、25.1%；分别为24.0%、2.0%和0%。M1切除组的生存率低于M0切除组（p = 0.009），但明显优于M1未切除组（p = 0.001）。单因素分析显示癌胚抗原bbb80 ng/ml和非r0切除与死亡相关。多因素分析显示，与未切除的M1组相比，M1切除组的生存率有所提高。PD联合同步肝转移切除术治疗低转移性PDAC是安全可行的，它可能为选定的患者提供生存益处。在一个大容量外科中心进行了一项回顾性病例对照研究。50例患者行胰十二指肠切除术并同步肝转移切除术。M1切除组、M0切除组和M1不切除组并发症相似。癌胚抗原bbb80 ng/ml和非r0切除与死亡相关。M1切除组生存率明显高于未切除的M1组。
Resection of pancreatic ductal adenocarcinoma (PDAC) with synchronous liver metastasectomy is still a matter of debate. We aimed to evaluate the feasibility of synchronous resection of PDAC and liver metastases for curative intent at a high-volume surgical center. Patients who underwent pancreaticoduodenectomy (PD) with synchronous liver metastasectomy (M1 resection group, n = 50) were matched 1 : 1 based on tumor and nodular stage, age, gender, body mass index and concomitant disease with two control groups (M0 resection and M1 no resection). The M0 resection group included patients who underwent PD without metastases. The M1 no resection group included patients with liver metastases who underwent palliative bypass or exploratory laparotomy without resection followed by palliative and adjuvant therapies. M1 resection group had a longer operation time, larger intraoperative blood loss, and longer postoperative hospital stay than other two groups. R0 resection rate of M1 resection group was similar to that of M0 resection group (92% vs. 94%, p = 1.000). Postoperative complications were comparable between the groups. The overall median survival in M1 resection, M0 resection, and M1 no resection group was 16, 30, and 6 months, respectively. Cumulative survival rates for 1-, 2-, and 3-year of the M1 resection, M0 resection, and M1 no resection group were 63.8%, 29.0%, and 6.7%; 94.0%, 74.4%, and 25.1%; 24.0%, 2.0%, and 0%, respectively. The survival of M1 resection group was worse than that of M0 resection group (p = 0.009), however significantly much better than that of M1 no resection group (p = 0.001). Univariate analysis showed carcinoembryonic antigen >8 ng/ml and non-R0 resection were associated with death. Multivariate analysis revealed that M1 resection group had improved survival compared with M1 no resection group. PD with synchronous liver metastasectomy for oligometastatic PDAC is safe and feasible, it might provide survival benefits for selected patients. A retrospective, case–control study was conducted at a high-volume surgical center. 50 patients underwent pancreaticoduodenectomy with synchronous liver metastasectomy. Complications were similar in M1 resection, M0 resection and M1 no resection groups. Carcinoembryonic antigen >8 ng/ml and non-R0 resection were associated with death. The survival of M1 resection group was much better than that of M1 no resection.
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DOI：
10.1007/s13304-015-0283-6
发表时间：
2015-03-01
期刊：
UPDATES IN SURGERY-ITALY
影响因子：
--
作者：
Zanini，Nicola;Lombardi，Raffaele;Jovine，Elio
通讯作者：
Jovine，Elio
影响因子：
254.7
作者：
Jemal, Ahmedin;Siegel, Rebecca;Thun, Michael J.
通讯作者：
Thun, Michael J.
影响因子：
4.3
作者：
Oweira H;Petrausch U;Helbling D;Schmidt J;Mannhart M;Mehrabi A;Schöb O;Giryes A;Decker M;Abdel-Rahman O
通讯作者：
Abdel-Rahman O
影响因子：
3.7
作者：
Shrikhande, Shailesh V.;Kleff, Joerg;Buechler, Markus W.
通讯作者：
Buechler, Markus W.
影响因子：
3.8
作者：
Crippa, S.;Bittoni, A.;Falconi, M.
通讯作者：
Falconi, M.