Arterial Resection During Pancreatectomy for Pancreatic Cancer: A Systematic Review and Meta-Analysis
@article{Mollberg2011ArterialRD, title={Arterial Resection During Pancreatectomy for Pancreatic Cancer: A Systematic Review and Meta-Analysis}, author={Nathan M. Mollberg and Nuh N. Rahbari and Moritz Koch and Werner Hartwig and Yumiko E. Hoeger and Markus W. B{\"u}chler and J{\"u}rgen Weitz}, journal={Annals of Surgery}, year={2011}, volume={254}, pages={882–893} }
Background:The majority of pancreatic cancers are diagnosed at an advanced stage. As surgical resection remains the only hope for cure, more aggressive surgical approaches have been advocated to increase resection rates. Institutions have begun to release data on their experience with pancreatectomy and simultaneous arterial resection (AR), which has traditionally been considered a general contraindication to resection. The aim of the present meta-analysis was to evaluate the perioperative and…
391 Citations
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A survival benefit of neoadjuvant chemotherapy was identified, compared to upfront surgery, and pancreatectomy with AR for advanced pancreatic cancer showed acceptable procedure-related morbidity and mortality.
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It is concluded that pancreatectomy with AR could be conducted under the comprehensive consideration of patients’ conditions, and it may be especially beneficial for those who have the probability to achieve R0 resection.
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Pancreatectomy with arterial resection may be safely performed in high-volume centers with acceptable survival results in highly selected patients, and pooling of data through a multi-institutional registry will allow a more accurate assessment of the safety and efficacy of this treatment strategy.
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Tumor resection with arterial reconstruction following intensive preoperative chemotherapy (plus radiochemotherapy in some cases) should be considered in selected patients, as it can prolong survival and potentially lead to sustained freedom from tumor recurrence.
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