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Radical antegrade modular pancreatosplenectomy versus standard procedure in the treatment of left-sided pancreatic cancer: A systemic review and meta-analysis

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机构: [1]Department of General Surgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, People’s Republic of China
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关键词: Pancreatic body/tail cancer Surgery R0 Overall survival Disease-free survival

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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.

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出版当年[2016]版:
大类 | 4 区 医学
小类 | 4 区 外科
最新[2023]版:
大类 | 3 区 医学
小类 | 3 区 外科
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出版当年[2015]版:
Q3 SURGERY
最新[2023]版:
Q2 SURGERY

影响因子: 最新[2023版] 最新五年平均 出版当年[2015版] 出版当年五年平均 出版前一年[2014版] 出版后一年[2016版]

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第一作者机构: [1]Department of General Surgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, People’s Republic of China
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通讯机构: [1]Department of General Surgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, People’s Republic of China
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