Detailed Abstract
[Poster Presentation 4 - Biliary & Pancreas (Pancreas Disease/Surgery)]
[BP PP 4-S4] An Arising Role of Local Treatment in an Era of Effective Chemotherapy in Pancreatic Cancer with Liver Metastasis: a Systematic Review And Meta-Analysis
Won-Gun YUN 1, Young Jae CHO 1, Youngmin HAN 1, Yoon Soo CHAE 1, Hye-Sol JUNG 1, Mirang LEE 1, Wooil KWON 1, Jin-Young JANG 1
1 Department of Surgery And Cancer Research Institute, Seoul National University Hospital, REPUBLIC OF KOREA
Background : Approximately half of the patients with pancreatic cancer had distant metastasis at the time of diagnosis. Liver is the most frequent location of metastasis and also associated with poor prognosis. As more patients have stable liver metastasis by advanced chemotherapy regimens, local treatment has been tried more often. However, the efficacy of local treatment remains unclear.
Methods : PubMed, Embase, and Cochrane were searched for studies reporting the survival outcomes of pancreatic cancer patients with isolated synchronous or metachronous liver metastasis who underwent curative-intent local treatment or just systemic treatment. Hazard ratios according to treatment strategy were pooled with a random-effects model, and survival outcomes were also pooled.
Results : The full texts of 98 studies were screened. Fourteen retrospective studies were included in this meta-analysis. Among patients with isolated synchronous liver metastasis, overall survival was significantly better in patients who underwent curative-intent local treatment compared to those who did not undergo (Hazard ratio 0.35, 95% confidence interval 0.24–0.52). Regarding treatment sequence, patients who underwent chemotherapy first followed by local treatment showed significantly better survival outcomes than those underwent immediate local treatment (46.0 months vs. 9.1 months; P < 0.001). Among patients with isolated metachronous liver metastasis, overall survival was also significantly better in patients who underwent curative-intent local treatment compared to those who did not undergo (Hazard ratio 0.37, 95% confidence interval 0.19–0.73).
Conclusions : Curative-intent local treatment could be a feasible treatment option for highly selected pancreatic cancer patients with liver metastasis.
Methods : PubMed, Embase, and Cochrane were searched for studies reporting the survival outcomes of pancreatic cancer patients with isolated synchronous or metachronous liver metastasis who underwent curative-intent local treatment or just systemic treatment. Hazard ratios according to treatment strategy were pooled with a random-effects model, and survival outcomes were also pooled.
Results : The full texts of 98 studies were screened. Fourteen retrospective studies were included in this meta-analysis. Among patients with isolated synchronous liver metastasis, overall survival was significantly better in patients who underwent curative-intent local treatment compared to those who did not undergo (Hazard ratio 0.35, 95% confidence interval 0.24–0.52). Regarding treatment sequence, patients who underwent chemotherapy first followed by local treatment showed significantly better survival outcomes than those underwent immediate local treatment (46.0 months vs. 9.1 months; P < 0.001). Among patients with isolated metachronous liver metastasis, overall survival was also significantly better in patients who underwent curative-intent local treatment compared to those who did not undergo (Hazard ratio 0.37, 95% confidence interval 0.19–0.73).
Conclusions : Curative-intent local treatment could be a feasible treatment option for highly selected pancreatic cancer patients with liver metastasis.
SESSION
Poster Presentation 4
Zone E 3/21/2024 2:50 PM - 3:30 PM