Top

World Journal of Surgical Oncology

Published in:

Open Access 01-12-2013 | Research

RETRACTED ARTICLE: Meta-analysis of the efficacy of pancreatoduodenectomy with extended lymphadenectomy in the treatment of pancreatic cancer

Authors: Xinbao Xu, Hui Zhang, Ping Zhou, Lei Chen

Published in: World Journal of Surgical Oncology | Issue 1/2013

Abstract

Background

The purpose of this meta-analysis is to compare the efficacy of pancreatoduodenectomy (PD) with extended lymphadenectomy (PD/ELND) versus standard PD in the treatment of pancreatic cancer, with the hope of providing evidence for clinical practice.

Methods

The retrieval of relevant literature published before September 2012 was carried out on PubMed, Medline, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL) by computer. Information was extracted according to Cochrane systematic review methods, and analyzed using software Stata 11.0.

Results

Five prospective randomized controlled trials (RCTs) were included in this meta-analysis of 555 cases (278 in the PD/ELND group and 277 in the standard PD group). The PD/ELND group showed a significantly lower 3-year survival rate (relative risk (RR) = 1.46, 95% confidence interval (CI) 1.03 to approximately 2.06, P = 0.034), prolonged operative time (weighted mean difference WMD = −1.03, 95% CI −1.96 to approximately −0.10, P = 0.029) and higher incidence of postoperative complications (RR = 0.56, 95% CI 0.42 to approximately 0.77, P = 0.000) by comparing with standard PD group. Besides, no significant difference was observed in the 1-year survival rate (RR = 0.87, 95% CI 0.60 to approximately 1.25, P = 0.69), 5-year survival rate (RR = 1.04, 95% CI 0.68 to approximately 1.58, P = 0.854), postoperative mortality (RR = 1.14, 95% CI 0.43 to approximately 3.00, P = 0.789), length of stay (WMD = −0.32, 95% CI −2.57 to approximately 1.94 , P = 0.784) and the amount of blood transfusions (WMD = −0.14, 95% CI −0.36 to approximately 0.08, P = 0.213).

Conclusions

PD/ELND does not have an advantage over standard PD in the survival rate for patients with pancreatic cancer, but does increase operative time and incidences of postoperative complications.

Available only for authorised users

Han SS, Kim SW, Jang JY, Park YH: A comparison of the long-term functional outcomes of standard pancreatoduodenectomy and pylorus-preserving pancreatoduodenectomy. Hepatogastroenterology. 2007, 54: 1831-1835.PubMed

Jemal A, Siegel R, Ward E, Murray T, Xu J, Thun MJ: Cancer statistics, 2007. CA Cancer J Clin. 2007, 57: 43-66. 10.3322/canjclin.57.1.43.CrossRefPubMed

Wagner M, Redaelli C, Lietz M, Seiler CA, Friess H, Buchler MW: Curative resection is the single most important factor determining outcome in patients with pancreatic adenocarcinoma. Br J Surg. 2004, 91: 586-594. 10.1002/bjs.4484.CrossRefPubMed

Loos M, Kleeff J, Friess H, Buchler MW: Surgical treatment of pancreatic cancer. Ann N Y Acad Sci. 2008, 1138: 169-180. 10.1196/annals.1414.024.CrossRefPubMed

Fortner JG: Regional resection of cancer of the pancreas: a new surgical approach. Surgery. 1973, 73: 307-320.PubMed

Ishikawa O, Ohhigashi H, Sasaki Y, Kabuto T, Fukuda I, Furukawa H, Imaoka S, Iwanaga T: Practical usefulness of lymphatic and connective tissue clearance for the carcinoma of the pancreas head. Ann Surg. 1988, 208: 215-220. 10.1097/00000658-198808000-00014.PubMedCentralCrossRefPubMed

Manabe T, Ohshio G, Baba N, Miyashita T, Asano N, Tamura K, Yamaki K, Nonaka A, Tobe T: Radical pancreatectomy for ductal cell carcinoma of the head of the pancreas. Cancer. 1989, 64: 1132-1137. 10.1002/1097-0142(19890901)64:5<1132::AID-CNCR2820640528>3.0.CO;2-V.CrossRefPubMed

Naganuma T, Isaji S, Kawarada Y: Staging and extended resection for pancreatic cancer. Pancreas. 1998, 16: 355-362. 10.1097/00006676-199804000-00024.CrossRefPubMed

Satake K, Nishiwaki H, Yokomatsu H, Kawazoe Y, Kim K, Haku A, Umeyama K, Miyazaki I: Surgical curability and prognosis for standard versus extended resection for T1 carcinoma of the pancreas. Surg Gynecol Obstet. 1992, 175: 259-265.PubMed

10.

Pedrazzoli S, DiCarlo V, Dionigi R, Mosca F, Pederzoli P, Pasquali C, Kloppel G, Dhaene K, Michelassi F: Standard versus extended lymphadenectomy associated with pancreatoduodenectomy in the surgical treatment of adenocarcinoma of the head of the pancreas: a multicenter, prospective, randomized study. Lymphadenectomy Study Group. Ann Surg. 1998, 228: 508-517. 10.1097/00000658-199810000-00007.PubMedCentralCrossRefPubMed

11.

Farnell MB, Pearson RK, Sarr MG, DiMagno EP, Burgart LJ, Dahl TR, Foster N, Sargent DJ: A prospective randomized trial comparing standard pancreatoduodenectomy with pancreatoduodenectomy with extended lymphadenectomy in resectable pancreatic head adenocarcinoma. Surgery. 2005, 138: 618-628. 10.1016/j.surg.2005.06.044. discussion 628–630CrossRefPubMed

12.

Yeo CJ, Cameron JL, Lillemoe KD, Sohn TA, Campbell KA, Sauter PK, Coleman J, Abrams RA, Hruban RH: Pancreaticoduodenectomy with or without distal gastrectomy and extended retroperitoneal lymphadenectomy for periampullary adenocarcinoma, part 2: randomized controlled trial evaluating survival, morbidity, and mortality. Ann Surg. 2002, 236: 355-366. 10.1097/00000658-200209000-00012. discussion 366–358PubMedCentralCrossRefPubMed

13.

Riall TS, Cameron JL, Lillemoe KD, Campbell KA, Sauter PK, Coleman J, Abrams RA, Laheru D, Hruban RH, Yeo CJ: Pancreaticoduodenectomy with or without distal gastrectomy and extended retroperitoneal lymphadenectomy for periampullary adenocarcinoma–part 3: update on 5-year survival. J Gastrointest Surg. 2005, 9: 1191-1204. 10.1016/j.gassur.2005.08.034. discussion 1204–1206CrossRefPubMed

14.

Nimura Y, Nagino M, Takao S, Takada T, Miyazaki K, Kawarada Y, Miyagawa S, Yamaguchi A, Ishiyama S, Takeda Y, Sakoda K, Kinoshita T, Yasui K, Shimada H, Katoh H: Standard versus extended lymphadenectomy in radical pancreatoduodenectomy for ductal adenocarcinoma of the head of the pancreas: long-term results of a Japanese multicenter randomized controlled trial. J Hepatobiliary Pancreat Sci. 2012, 19: 230-241. 10.1007/s00534-011-0466-6.CrossRefPubMed

15.

Kayahara M, Nagakawa T, Ueno K, Ohta T, Tsukioka Y, Miyazaki I: Surgical strategy for carcinoma of the pancreas head area based on clinicopathologic analysis of nodal involvement and plexus invasion. Surgery. 1995, 117: 616-623. 10.1016/S0039-6060(95)80003-4.CrossRefPubMed

16.

Mukaiya M, Hirata K, Satoh T, Kimura M, Yamashiro K, Ura H, Oikawa I, Denno R: Lack of survival benefit of extended lymph node dissection for ductal adenocarcinoma of the head of the pancreas: retrospective multi-institutional analysis in Japan. World J Surg. 1998, 22: 248-252. 10.1007/s002689900378. discussion 252–253CrossRefPubMed

17.

Iqbal N, Lovegrove RE, Tilney HS, Abraham AT, Bhattacharya S, Tekkis PP, Kocher HM: A comparison of pancreaticoduodenectomy with extended pancreaticoduodenectomy: a meta-analysis of 1909 patients. Eur J Surg Oncol. 2009, 35: 79-86. 10.1016/j.ejso.2008.01.002.CrossRefPubMed

18.

Cserni G, Gregori D, Merletti F, Sapino A, Mano MP, Ponti A, Sandrucci S, Baltas B, Bussolati G: Meta-analysis of non-sentinel node metastases associated with micrometastatic sentinel nodes in breast cancer. Br J Surg. 2004, 91: 1245-1252. 10.1002/bjs.4725.CrossRefPubMed

19.

Kim T, Giuliano AE, Lyman GH: Lymphatic mapping and sentinel lymph node biopsy in early-stage breast carcinoma: a metaanalysis. Cancer. 2006, 106: 4-16. 10.1002/cncr.21568.CrossRefPubMed

20.

Zetoune T, Keutgen X, Buitrago D, Aldailami H, Shao H, Mazumdar M, Fahey TJ, Zarnegar R: Prophylactic central neck dissection and local recurrence in papillary thyroid cancer: a meta-analysis. Ann Surg Oncol. 2010, 17: 3287-3293. 10.1245/s10434-010-1137-6.CrossRefPubMed

21.

Chisholm EJ, Kulinskaya E, Tolley NS: Systematic review and meta-analysis of the adverse effects of thyroidectomy combined with central neck dissection as compared with thyroidectomy alone. Laryngoscope. 2009, 119: 1135-1139. 10.1002/lary.20236.CrossRefPubMed

Title: RETRACTED ARTICLE: Meta-analysis of the efficacy of pancreatoduodenectomy with extended lymphadenectomy in the treatment of pancreatic cancer
Authors: Xinbao Xu
Hui Zhang
Ping Zhou
Lei Chen
Publication date: 01-12-2013
Publisher: BioMed Central
Published in: World Journal of Surgical Oncology / Issue 1/2013
Electronic ISSN: 1477-7819
DOI: https://doi.org/10.1186/1477-7819-11-311

Keynote webinar | Spotlight on medication adherence

Springer Medicine

RETRACTED ARTICLE: Meta-analysis of the efficacy of pancreatoduodenectomy with extended lymphadenectomy in the treatment of pancreatic cancer

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2013

Surgical resection should be taken into consideration for the treatment of small gastric gastrointestinal stromal tumors

Routine use of positron-emission tomography/computed tomography for staging of primary colorectal cancer: Does it affect clinical management?

Marjolin’s ulcer: a preventable malignancy arising from scars

Metachronous, colitis-associated rectal cancer that developed after sporadic adenocarcinoma in an adenoma in a patient with longstanding Crohn’s disease: a case report

Dedifferentiated chondrosarcoma of the cervical spine: a case report

Sarcoidosis lymphoma syndrome - the value of PET-CT in the diagnosis