胰瘘会影响胰腺癌切除术后的长期生存吗？一项系统评价和荟萃分析。
Does Pancreatic Fistula Affect Long-Term Survival after Resection for Pancreatic Cancer? A Systematic Review and Meta-Analysis.
作者信息
Grego Andrea, Friziero Alberto, Serafini Simone, Belluzzi Amanda, Moletta Lucia, Saadeh Luca Maria, Sperti Cosimo
机构信息
Department of Surgery, Oncology and Gastroenterology, 3rd Surgery Clinic, University of Padua, Via Giustiniani 2, 35128 Padua, Italy.
出版信息
Cancers (Basel). 2021 Nov 19;13(22):5803. doi: 10.3390/cancers13225803.
BACKGROUND
The impact of postoperative pancreatic fistula (POPF) on survival after resection for pancreatic ductal adenocarcinoma (PDAC) remains unclear.
METHODS
The MEDLINE, Scopus, Embase, Web of Science, and Cochrane Library databases were searched for studies reporting on survival in patients with and without POPF. A meta-analysis was performed to investigate the impact of POPF on disease-free survival (DFS) and overall survival (OS).
RESULTS
Sixteen retrospective cohort studies concerning a total of 5019 patients with an overall clinically relevant POPF (CR-POPF) rate of 12.63% (n = 634 patients) were considered. Five of eleven studies including DFS data reported higher recurrence rates in patients with POPF, and one study showed a higher recurrence rate in the peritoneal cavity. Six of sixteen studies reported worse OS rates in patients with POPF. Sufficient data for a meta-analysis were available in 11 studies for DFS, and in 16 studies for OS. The meta-analysis identified a shorter DFS in patients with CR-POPF (HR 1.59, = 0.0025), and a worse OS in patients with POPF, CR-POPF (HR 1.15, = 0.0043), grade-C POPF (HR 2.21, = 0.0007), or CR-POPF after neoadjuvant therapy.
CONCLUSIONS
CR-POPF after resection for PDAC is significantly associated with worse overall and disease-free survival.
背景
术后胰瘘（POPF）对胰腺导管腺癌（PDAC）切除术后生存的影响尚不清楚。
方法
检索MEDLINE、Scopus、Embase、科学网和Cochrane图书馆数据库，查找报告有或无POPF患者生存情况的研究。进行荟萃分析以研究POPF对无病生存期（DFS）和总生存期（OS）的影响。
结果
共纳入16项回顾性队列研究，涉及5019例患者，总体临床相关胰瘘（CR-POPF）发生率为12.63%（n = 634例患者）。11项包含DFS数据的研究中有5项报告POPF患者复发率更高，1项研究显示腹腔复发率更高。16项研究中有6项报告POPF患者的OS率更差。11项研究有足够的数据用于DFS的荟萃分析，16项研究有足够的数据用于OS的荟萃分析。荟萃分析发现CR-POPF患者的DFS更短（HR 1.59， = 0.0025），POPF、CR-POPF患者（HR 1.15， = 0.0043）、C级POPF患者（HR 2.21， = 0.0007）或新辅助治疗后CR-POPF患者的OS更差。
结论
PDAC切除术后的CR-POPF与总体和无病生存期较差显著相关。
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