TY - JOUR
T1 - Extended distal pancreatectomy in pancreatic cancer
T2 - is it justified? A systematic review of literature
AU - Chandrashekhar, Sagar H.
AU - Ismail, Simi
AU - Jonnada, Pavan K.
AU - Senadhipan, Baiju
AU - Karunakaran, Monish
AU - Barreto, Savio George
PY - 2023/5/12
Y1 - 2023/5/12
N2 - Background: Extended distal pancreatectomy (EDP) is being increasingly performed for pancreatic cancers with suspected invasion into the adjacent organs. However, the perioperative safety and oncological efficacy of this procedure merit further elucidation. Methods: Major databases were searched for studies evaluating EDP, and a meta-analysis was performed using fixed- or random-effects models. Results: Fifteen studies were included in the analysis. EDP was found to be associated with significantly greater incidence of postoperative pancreatic fistula overall and with major complications, re-explorations, mortality and readmissions. However, on pooled analysis of 3- and 5-year survival, EDP was found to be noninferior to standard distal pancreatectomy. Conclusion: EDP is feasible and may offer equivalent survival in highly selected patients but carries a higher risk of perioperative morbidity and mortality.
AB - Background: Extended distal pancreatectomy (EDP) is being increasingly performed for pancreatic cancers with suspected invasion into the adjacent organs. However, the perioperative safety and oncological efficacy of this procedure merit further elucidation. Methods: Major databases were searched for studies evaluating EDP, and a meta-analysis was performed using fixed- or random-effects models. Results: Fifteen studies were included in the analysis. EDP was found to be associated with significantly greater incidence of postoperative pancreatic fistula overall and with major complications, re-explorations, mortality and readmissions. However, on pooled analysis of 3- and 5-year survival, EDP was found to be noninferior to standard distal pancreatectomy. Conclusion: EDP is feasible and may offer equivalent survival in highly selected patients but carries a higher risk of perioperative morbidity and mortality.
KW - distal pancreatectomy
KW - extended resections
KW - outcomes
KW - pancreatic cancer
KW - survival
UR - http://www.scopus.com/inward/record.url?scp=85162224829&partnerID=8YFLogxK
U2 - 10.2217/fon-2022-1180
DO - 10.2217/fon-2022-1180
M3 - Review article
C2 - 37170878
AN - SCOPUS:85162224829
SN - 1479-6694
VL - 19
SP - 873
EP - 885
JO - Future Oncology
JF - Future Oncology
IS - 12
ER -
