Meta-analysis of recurrence pattern after resection for pancreatic cancer

Abstract

Background: Initial recurrence mapping of resected pancreatic ductal adenocarcinoma (PDAC) could help in stratifying patient subpopulations for optimal postoperative follow-up. The aim of this systematic review and meta-analysis was to investigate the initial recurrence patterns of PDAC and to correlate them with clinicopathological factors.Methods: MEDLINE and Web of Science databases were searched systematically for studies reporting first recurrence patterns after PDAC resection. Data were extracted from the studies selected for inclusion. Pooled odds ratios (ORs) and 95 per cent confidence intervals were calculated to determine the clinicopathological factors related to the recurrence sites. The weighted average of median overall survival was calculated.Results: Eighty-nine studies with 17 313 patients undergoing PDAC resection were included. The weighted median rates of initial recurrence were 20⋅8 per cent for locoregional sites, 26⋅5 per cent for liver, 11⋅4 per cent for lung and 13⋅5 per cent for peritoneal dissemination. The weighted median overall survival times were 19⋅8 months for locoregional recurrence, 15⋅0 months for liver recurrence, 30⋅4 months for lung recurrence and 14⋅1 months for peritoneal dissemination. Meta-analysis revealed that R1 (direct) resection (OR 2⋅21, 95 per cent c.i. 1⋅12 to 4⋅35), perineural invasion (OR 5⋅19, 2⋅79 to 9⋅64) and positive peritoneal lavage cytology (OR 5⋅29, 3⋅03 to 9⋅25) were significantly associated with peritoneal dissemination as initial recurrence site. Low grade of tumour differentiation was significantly associated with liver recurrence (OR 4⋅15, 1⋅71 to 10⋅07).

Systematic Analysis of Accuracy in Predicting Complete Oncological Resection in Pancreatic Cancer Patients—Proposal of a New Simplified Borderline Resectability Definition

“…It may also be speculated that perivascular SMA stranding is a morphological correlate of very pronounced perineural invasion. Perineural invasion is well-known as one of the main causes of local tumor recurrence and metastasis and was demonstrated as one of the major prognostic parameters in PDAC [21][22][23]. In the current study, perivascular SMA stranding qualified as an independent prognostic factor, stronger than established prognostic parameters like ASA score, N status, lymphovascular invasion or R status.…”

Hepatic Arterial Infusion Chemotherapy for Liver Metastases Following Standard Chemotherapy for Pancreatic Cancer

“…After the radical resection of pancreatic cancer, approximately 80% of patients would develop recurrence (3). A meta-analysis showed that the weighted median rate of initial recurrence in the liver after resection of pancreatic cancer was 26.5% (5). Pancreatic cancer has a poor prognosis for postoperative recurrence, especially liver recurrence (3,6).…”

A Prognostic Prediction Model Developed Based on Four CpG Sites and Weighted Correlation Network Analysis Identified DNAJB1 as a Novel Biomarker for Pancreatic Cancer

“…Therefore, the development of a risk stratification model may help clinicians to design personalized treatment programs for different patients. Previous studies have proposed various risk stratification models for the diagnosis, prognosis, and recurrence of pancreatic cancer, which exhibited better efficiency than the classical TNM stage (43)(44)(45). The rapid development of sequencing techniques has enabled the access to multi-omics data and high-quality clinical information through different databases, such as TCGA, ICGC, and Gene Expression Omnibus (17,46,47).…”