A Systematic review and meta-analysis on the role of palliative primary resection for pancreatic neuroendocrine neoplasm with liver metastases

S Partelli, Roberto Cirocchi, PMV Rancoita, F Muffatti, V Andreasi, S Crippa, D Tamburrino, M Falconi

Research output: Contribution to journalArticle

Abstract

Background: Role of palliative pancreatic neuroendocrine neoplasm (PanNEN) resection (pPanNEN-R) is controversial. This study was designed as a meta-analysis of studies which allow a comparison of pPanNEN-R and non-surgical management (PanNEN-nR). Methods: All published studies until 2017 allowing for the comparison of pPanNEN-R and PanNEN-nR were reviewed. Primary outcome was overall survival (OS). Secondary outcomes measures included postoperative morbidity, reoperation, readmission, length of hospital stay (LOS), and quality of life (QoL). Risk of death was compared by computing the odds-ratio (OR), while 5- and 10-year OS using weighted mean differences. Results: Seven studies were included. A total of 885 patients were included, of whom 252 (28%) underwent pPanNEN-R and 633 (72%) underwent PanNEN-nR. Overall quality of included studies was fair. The risk of death was significantly reduced in patients who underwent pPanNEN-R compared to those who underwent PanNEN-nR (OR = 0.38, 95% CI 0.23-0.65). Data on postoperative morbidity, reoperation, readmission, LOS, and QoL were not adequately reported therefore a meta-analysis for the secondary outcomes was not performed. Discussion: pPanNEN-R in patients with unresectable LM seems to be associated with a better OS compared to non-surgical management but the limitations of included studies does not allow firm conclusions. © 2017 International Hepato-Pancreato-Biliary Association Inc.
Original languageEnglish
Pages (from-to)197-203
Number of pages7
JournalHPB
Volume20
Issue number3
DOIs
Publication statusPublished - 2018

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Pancreatic Neoplasms
Meta-Analysis
Neoplasm Metastasis
Liver
Length of Stay
Reoperation
Survival
Odds Ratio
Quality of Life
Morbidity
Outcome Assessment (Health Care)

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A Systematic review and meta-analysis on the role of palliative primary resection for pancreatic neuroendocrine neoplasm with liver metastases. / Partelli, S; Cirocchi, Roberto; Rancoita, PMV; Muffatti, F; Andreasi, V; Crippa, S; Tamburrino, D; Falconi, M.

In: HPB, Vol. 20, No. 3, 2018, p. 197-203.

Research output: Contribution to journalArticle

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T1 - A Systematic review and meta-analysis on the role of palliative primary resection for pancreatic neuroendocrine neoplasm with liver metastases

AU - Partelli, S

AU - Cirocchi, Roberto

AU - Rancoita, PMV

AU - Muffatti, F

AU - Andreasi, V

AU - Crippa, S

AU - Tamburrino, D

AU - Falconi, M

PY - 2018

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N2 - Background: Role of palliative pancreatic neuroendocrine neoplasm (PanNEN) resection (pPanNEN-R) is controversial. This study was designed as a meta-analysis of studies which allow a comparison of pPanNEN-R and non-surgical management (PanNEN-nR). Methods: All published studies until 2017 allowing for the comparison of pPanNEN-R and PanNEN-nR were reviewed. Primary outcome was overall survival (OS). Secondary outcomes measures included postoperative morbidity, reoperation, readmission, length of hospital stay (LOS), and quality of life (QoL). Risk of death was compared by computing the odds-ratio (OR), while 5- and 10-year OS using weighted mean differences. Results: Seven studies were included. A total of 885 patients were included, of whom 252 (28%) underwent pPanNEN-R and 633 (72%) underwent PanNEN-nR. Overall quality of included studies was fair. The risk of death was significantly reduced in patients who underwent pPanNEN-R compared to those who underwent PanNEN-nR (OR = 0.38, 95% CI 0.23-0.65). Data on postoperative morbidity, reoperation, readmission, LOS, and QoL were not adequately reported therefore a meta-analysis for the secondary outcomes was not performed. Discussion: pPanNEN-R in patients with unresectable LM seems to be associated with a better OS compared to non-surgical management but the limitations of included studies does not allow firm conclusions. © 2017 International Hepato-Pancreato-Biliary Association Inc.

AB - Background: Role of palliative pancreatic neuroendocrine neoplasm (PanNEN) resection (pPanNEN-R) is controversial. This study was designed as a meta-analysis of studies which allow a comparison of pPanNEN-R and non-surgical management (PanNEN-nR). Methods: All published studies until 2017 allowing for the comparison of pPanNEN-R and PanNEN-nR were reviewed. Primary outcome was overall survival (OS). Secondary outcomes measures included postoperative morbidity, reoperation, readmission, length of hospital stay (LOS), and quality of life (QoL). Risk of death was compared by computing the odds-ratio (OR), while 5- and 10-year OS using weighted mean differences. Results: Seven studies were included. A total of 885 patients were included, of whom 252 (28%) underwent pPanNEN-R and 633 (72%) underwent PanNEN-nR. Overall quality of included studies was fair. The risk of death was significantly reduced in patients who underwent pPanNEN-R compared to those who underwent PanNEN-nR (OR = 0.38, 95% CI 0.23-0.65). Data on postoperative morbidity, reoperation, readmission, LOS, and QoL were not adequately reported therefore a meta-analysis for the secondary outcomes was not performed. Discussion: pPanNEN-R in patients with unresectable LM seems to be associated with a better OS compared to non-surgical management but the limitations of included studies does not allow firm conclusions. © 2017 International Hepato-Pancreato-Biliary Association Inc.

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