Radical antegrade modular pancreatosplenectomy versus standard procedure in the treatment of left-sided pancreatic cancer: A systemic review and meta-analysis
Background: Radical antegrade modular pancreatosplenectomy (RAMPS), first reported by Strasberg in 2003, has attracted increasing attention in the treatment of left-sided pancreatic cancer. The limited number of cases eligible for RAMPS makes it difficult to perform any prospective randomized trial of RAMPS versus the standard procedure. Therefore, we performed this systemic review and meta-analysis of the current data to clarify the role of the RAMPS procedure. Methods: A literature search was performed in electronic databases, including PubMed, Medline, Embase, CNKI and the Cochrane Library. Studies comparing RAMPS with the standard procedure were included in this meta-analysis. R0 resection rate, recurrence rate at the end of the follow-up, overall survival (OS) and disease-free survival (DFS) were measured as primary outcomes. Revman 5.3 was used to perform the analysis. Results: Six retrospective cohort studies with a total number of 378 patients were included in our analysis. Meta-analysis revealed that RAMPS was correlated with higher R0 resection rates [Odds Ratio (OR) 95% confidence interval (CI), 2.19 (1.16 similar to 4.13); P = 0.02] and successful harvest of more lymph nodes [weighted mean difference (WMD) 95% CI, 7.06 (4.52 similar to 9.60); P < 0.01] compared with the standard procedure. However, no statistically significant difference was found between the procedures with respect to recurrence rates [OR 95% CI, 0.66 (0.40 similar to 1.09); P = 0.10], OS [Hazard ratio (HR) 95% CI, 0.65 (0.42 similar to 1.00); P = 0.05] or DFS [HR 95% CI, 1.02 (0.62 similar to 1.68); P = 0.93]. Conclusions: RAMPS is safe and oncologically superior to the standard procedure for the treatment of left-sided pancreatic cancer. However, high-grade evidence will be necessary to confirm the potential survival benefits of RAMPS.
基金:
Beijing Municipal Administration of Hospitals’Youth Programme, code: QML20160806.
第一作者机构:[1]Department of General Surgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, People’s Republic of China
共同第一作者:
通讯作者:
通讯机构:[1]Department of General Surgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, People’s Republic of China
推荐引用方式(GB/T 7714):
Feng Cao,Jia Li,Ang Li,et al.Radical antegrade modular pancreatosplenectomy versus standard procedure in the treatment of left-sided pancreatic cancer: A systemic review and meta-analysis[J].BMC SURGERY.2017,17(1):67.doi:10.1186/s12893-017-0259-1.
APA:
Feng Cao,Jia Li,Ang Li&Fei Li.(2017).Radical antegrade modular pancreatosplenectomy versus standard procedure in the treatment of left-sided pancreatic cancer: A systemic review and meta-analysis.BMC SURGERY,17,(1)
MLA:
Feng Cao,et al."Radical antegrade modular pancreatosplenectomy versus standard procedure in the treatment of left-sided pancreatic cancer: A systemic review and meta-analysis".BMC SURGERY 17..1(2017):67