Department of Surgery, Sapienza University, Rome, Italy.
Dig Surg. 2023;40(1-2):9-20. doi: 10.1159/000528823. Epub 2023 Feb 21.
A systematic review and meta-analysis of the literature was carried out to determine the clinical and oncological outcome of patients who had enucleation of solitary pancreatic metastases from renal cell carcinoma.
Operative mortality, postoperative complications, observed survival, and disease-free survival were analyzed. The clinical outcomes of patients who had enucleation were compared to those of 947 patients collected from the literature who had standard or atypical pancreatic resection for the same disease using propensity score matching.
There was no postoperative mortality in the 56 patients who had enucleation of pancreatic metastases from renal cell carcinoma. In 51 patients, postoperative complications could be analyzed. Ten patients (10/51 = 19.6%) had postoperative complications. Three patients (3/51 = 5.9%) had major complications (Clavien-Dindo III or more). Five-year observed survival rates and disease-free survival for patients with enucleation were 92% and 79%, respectively. These results compared favorably with those obtained in patients who had standard resection and other forms of atypical resection (also using propensity score matching). Patients who had partial pancreatic resection (atypical or not) with pancreatic-jejunal anastomosis had increased rates of postoperative complications and local recurrences.
Enucleation of pancreatic metastases offers a valid solution in selected patients.
对文献进行了系统回顾和荟萃分析，以确定因肾细胞癌而行单一胰腺转移灶剜除术患者的临床和肿瘤学结局。
分析手术死亡率、术后并发症、观察生存率和无疾病生存率。通过倾向评分匹配，将行剜除术患者的临床结局与从文献中收集的 947 例因相同疾病而行标准或非典型胰腺切除术患者的临床结局进行比较。
56 例因肾细胞癌而行胰腺转移灶剜除术的患者无术后死亡。在 51 例患者中，可以分析术后并发症。10 例患者（51 例中有 10 例= 19.6%）发生术后并发症。3 例患者（51 例中有 3 例= 5.9%）发生严重并发症（Clavien-Dindo III 级或更高级别）。行剜除术患者的 5 年观察生存率和无疾病生存率分别为 92%和 79%。这些结果与行标准切除术和其他形式的非典型切除术（同样使用倾向评分匹配）的患者相比具有优势。行胰肠吻合术的部分胰腺切除术（无论是否为非典型）患者术后并发症和局部复发的发生率增加。
在选择的患者中，胰腺转移灶剜除术是一种有效的治疗方法。
