Systematic Review and Meta-Analysis of Surgical Treatment for Isolated Local Recurrence of Pancreatic Cancer

• Main Authors: Simone Serafini, Cosimo Sperti, Alberto Friziero, Alessandra Rosalba Brazzale, Alessia Buratin, Alberto Ponzoni, Lucia Moletta
• Format: Article
• Language: English
• Published: MDPI AG 2021-03-01
• Series: Cancers
• Subjects: isolated local recurrence; pancreatectomy; pancreatic cancer; pancreatic remnant; recurrence; redo surgery
• Online Access: https://www.mdpi.com/2072-6694/13/6/1277

Purpose: To perform a systematic review and meta-analysis on the outcome of surgical treatment for isolated local recurrence of pancreatic cancer. Methods: A systematic review and meta-analysis based on Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines was conducted in PubMed, Scopus, and Web of Science. Results: Six studies concerning 431 patients with recurrent pancreatic cancer met the inclusion criteria and were included in the analysis: 176 underwent redo surgery, and 255 received non-surgical treatments. Overall survival and post-recurrence survival were significantly longer in the re-resected group (ratio of means (ROM) 1.99; 95% confidence interval (CI), 1.54–2.56, <i>I</i>² = 75.89%, <i>p</i> = 0.006, and ROM = 2.05; 95% CI, 1.48–2.83, <i>I</i>² = 76.39%, <i>p</i> = 0.002, respectively) with a median overall survival benefit of 28.7 months (mean difference (MD) 28.7; 95% CI, 10.3–47.0, <i>I</i>² = 89.27%, <i>p</i> < 0.001) and median survival benefit of 15.2 months after re-resection (MD 15.2; 95% CI, 8.6–21.8, <i>I</i>² = 58.22%, <i>p</i> = 0.048). Conclusion: Resection of isolated pancreatic cancer recurrences is safe and feasible and may offer a survival benefit. Selection of patients and assessment of time and site of recurrence are mandatory.