如何治疗肾细胞癌胰腺转移？一项荟萃分析。

How Should We Treat Pancreatic Metastases from Renal Cell Carcinoma? A Meta-Analysis.

机构信息

Department of Gastroenterological and Pediatric Surgery, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama-machi, Yufu, Oita, 879-5593, Japan.

Department of Urology, Faculty of Medicine, Oita University, 1-1 Hasama-machi, Yufu , Oita, 879-5593, Japan.

出版信息

World J Surg. 2021 Jul;45(7):2191-2199. doi: 10.1007/s00268-021-06071-x. Epub 2021 Mar 25.

DOI:10.1007/s00268-021-06071-x

PMID:33768307

Abstract

BACKGROUND

The treatment strategy for pancreatic metastasis (PM) from renal cell carcinoma (RCC) is unclear due to its rarity. The aim of this study was to reveal the role of surgery for PM from RCC.

METHODS

A systematic literature search was conducted using PubMed and the Cochrane Library. The effectiveness of surgery for PM was evaluated based on the primary outcome of overall survival (OS), which was investigated in relation to surgical procedures and metastatic sites via subgroup analyses.

RESULTS

There was no significant difference in the rate of 2-year OS between the surgery and control group (OR 0.43, 95% CI 0.14-1.26, P = 0.12). However, the rate of 5-year OS was significantly higher in the surgery group than the control group (OR = 0.41, 95% CI 0.18-0.93, P = 0.03). The rates of the complications and OS were not significantly different between radical and conservative pancreatectomies. The rate of 5-year OS of the patients with PM was higher than that with other metastases (OR 0.38, 95% CI 0.20-0.74, P = 0.004).

CONCLUSION

Surgical resection for PM from RCC is associated with good prognosis. Limited surgery may be a useful option depending on the location of the lesion.

摘要

背景

由于其罕见性，肾细胞癌（RCC）胰腺转移（PM）的治疗策略尚不明确。本研究旨在揭示手术治疗 RCC 胰腺转移的作用。

方法

通过 PubMed 和 Cochrane 图书馆进行系统文献检索。通过亚组分析，根据总生存（OS）这一主要结果评估手术治疗 PM 的效果，探讨手术方式和转移部位与 OS 的关系。

结果

手术组与对照组的 2 年 OS 率无显著差异（OR 0.43，95%CI 0.14-1.26，P=0.12）。然而，手术组的 5 年 OS 率明显高于对照组（OR=0.41，95%CI 0.18-0.93，P=0.03）。根治性和保守性胰腺切除术之间的并发症和 OS 发生率无显著差异。PM 患者的 5 年 OS 率高于其他转移患者（OR 0.38，95%CI 0.20-0.74，P=0.004）。