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Introduction <p>Pancreatic adenocarcinomas (PDAC) have a poor prognosis, with a 5-year relative Survival rate of 11.5%. Only 20% of patients are initially eligible for resection, and 50% of patients presented with metastatic disease, currently only candidates’ palliative treatment. This meta-analysis compares the outcomes of surgical treatment versus chemotherapy or palliative care for M-PDAC.</p> Methods <p>A literature search was performed on May, 9th of 2024. A meta-analysis was then conducted. The primary outcome was Overall Survival and the secondary outcomes were 1-year Survival and 3-year survival. Subgroup analysis was also performed, based on metastatic sites.</p> Results <p>The analyses showed a significant benefit of surgical treatment in terms of overall survival (HR: 0.42, 95% CI [0.33– 0.53]), 1-year survival (OR: 0.37, CI 95% [0.26, 0.52]), and 3-year survival (OR: 0.16, CI 95% [0.07, 0.383]). In the subgroup analysis based on metastatic site, the benefit of surgical treatment persisted for liver-only metastases (HR : 0.40, CI 95% [0.29, 0.53]), but not for lung-only metastases.</p> Conclusion <p>This meta-analysis showed a survival advantage for surgical treatment in patients with M-PDAC and especially in liver-only metastases. Prospective trials are needed to confirm these findings and refine patient selection criteria for surgical treatment.</p>

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Is there a chance for curative treatment for metastatic pancreatic adenocarcinoma? A systematic review with meta-analysis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年9月10日

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  • Kellil Tarek,
  • Tormane Mohamed Amine,
  • Rhaiem Rami,
  • Amara Amal,
  • Gianpaoli Francesca,
  • Sanchez Stephane,
  • Piardi Tullio

摘要

Introduction

Pancreatic adenocarcinomas (PDAC) have a poor prognosis, with a 5-year relative Survival rate of 11.5%. Only 20% of patients are initially eligible for resection, and 50% of patients presented with metastatic disease, currently only candidates’ palliative treatment. This meta-analysis compares the outcomes of surgical treatment versus chemotherapy or palliative care for M-PDAC.

Methods

A literature search was performed on May, 9th of 2024. A meta-analysis was then conducted. The primary outcome was Overall Survival and the secondary outcomes were 1-year Survival and 3-year survival. Subgroup analysis was also performed, based on metastatic sites.

Results

The analyses showed a significant benefit of surgical treatment in terms of overall survival (HR: 0.42, 95% CI [0.33– 0.53]), 1-year survival (OR: 0.37, CI 95% [0.26, 0.52]), and 3-year survival (OR: 0.16, CI 95% [0.07, 0.383]). In the subgroup analysis based on metastatic site, the benefit of surgical treatment persisted for liver-only metastases (HR : 0.40, CI 95% [0.29, 0.53]), but not for lung-only metastases.

Conclusion

This meta-analysis showed a survival advantage for surgical treatment in patients with M-PDAC and especially in liver-only metastases. Prospective trials are needed to confirm these findings and refine patient selection criteria for surgical treatment.