Lee Rachael Chang, Kanhere Harsh, Trochsler Markus, Broadbridge Vy, Maddern Guy, Price Timothy J
Department of Medical Oncology, the Queen Elizabeth Hospital, Adelaide 5011, Australia.
Department of Surgery, the Queen Elizabeth Hospital, Adelaide 5011, Australia.
World J Gastrointest Oncol. 2018 Aug 15;10(8):211-220. doi: 10.4251/wjgo.v10.i8.211.
To analyse the safety and efficacy of curative intent surgery in biliary and pancreatic cancer.
An extensive literature review was performed using MEDLINE, Google Scholar and EMBASE to identify articles regarding hepato-pancreatoduodenectomy or resection of liver metastasis in patients with pancreatic, biliary tract, periampullary and gallbladder cancers.
A total of 19 studies were identified and reviewed. Major hepatectomy was undertaken in 391 patients. The median overall survival for pancreatic cancer ranged from 5-36 mo and for biliary tract/gallbladder cancer, it was 8-38 mo. The 30 d mortality rate was only 1%-9%. Overall Survival was significantly better for patients, who had good response to neoadjuvant chemotherapy, underwent metachronous liver resection and who had intestinal type tumours.
Resection of liver metastases in pancreatic and biliary cancers may provide survival benefit without compromising safety and quality of life in a very select group of patients. These data may be utilised to formulate selection criteria that may allow future investigation of resection in the era of more effective systemic therapy.
分析根治性手术治疗胆管癌和胰腺癌的安全性及疗效。
利用医学文献数据库（MEDLINE）、谷歌学术和荷兰医学文摘数据库（EMBASE）进行广泛的文献综述，以确定有关肝胰十二指肠切除术或胰腺癌、胆管癌、壶腹周围癌及胆囊癌患者肝转移灶切除术的文章。
共识别并综述了19项研究。391例患者接受了大肝切除术。胰腺癌患者的中位总生存期为5 - 36个月，胆管癌/胆囊癌患者为8 - 38个月。30天死亡率仅为1% - 9%。对新辅助化疗反应良好、接受异时性肝切除且为肠型肿瘤的患者总生存期明显更长。
在经过严格挑选的一组患者中，切除胰腺癌和胆管癌的肝转移灶可能在不影响安全性和生活质量的情况下带来生存益处。这些数据可用于制定选择标准，以便在更有效的全身治疗时代对切除术进行未来的研究。
