Palliative resections versus palliative bypass procedures in pancreatic cancer—a systematic review
The American Journal of Surgery, 03/30/2012
Gillen S et al. – Pooled median survival times were 8.2 months for R2 resection and 6.7 months for palliative bypass procedures. Planned palliative R2 resections are not justified in patients with pancreatic cancer.Methods
- A systematic review and meta–analysis of studies of patients with pancreatic cancer was performed to analyze R2 resections in comparison with palliative surgical bypass procedures.
- Trials were identified by searching MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials from 1966 to February 2011.
- Four cohort studies were identified comparing 138 patients with R2 resections with 261 patients undergoing surgical bypass procedures.
- Morbidity and mortality were increased in the R2 resection group, with pooled risk ratios of 1.75 (95% confidence interval [CI], 1.35–2.26; P < .0001) and 2.98 (95% CI, 1.31–6.75; P = .009), respectively.
- R2 resections were associated with longer operating times (mean difference, 164 minutes; 95% CI, 127–201 minutes; P < .00001) and hospital stays (mean difference, 5 days; 95% CI, 1–9 days; P = .02).
- Pooled median survival times were 8.2 months for R2 resection and 6.7 months for palliative bypass procedures.