Does Pancreatic Fistula Affect Long-Term Survival after Resection for Pancreatic Cancer? A Systematic Review and Meta-Analysis

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...

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Autores principales:	Andrea Grego, Alberto Friziero, Simone Serafini, Amanda Belluzzi, Lucia Moletta, Luca Maria Saadeh, Cosimo Sperti
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	postoperative pancreatic fistula POPF survival overall survival pancreatic cancer pancreatectomy Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/a08b51c7c2634147b875558c28eb686d
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spelling	oai:doaj.org-article:a08b51c7c2634147b875558c28eb686d2021-11-25T17:04:12ZDoes Pancreatic Fistula Affect Long-Term Survival after Resection for Pancreatic Cancer? A Systematic Review and Meta-Analysis10.3390/cancers132258032072-6694https://doaj.org/article/a08b51c7c2634147b875558c28eb686d2021-11-01T00:00:00Zhttps://www.mdpi.com/2072-6694/13/22/5803https://doaj.org/toc/2072-6694Background: 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, <i>p</i> = 0.0025), and a worse OS in patients with POPF, CR-POPF (HR 1.15, <i>p</i> = 0.0043), grade-C POPF (HR 2.21, <i>p</i> = 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.Andrea GregoAlberto FrizieroSimone SerafiniAmanda BelluzziLucia MolettaLuca Maria SaadehCosimo SpertiMDPI AGarticlepostoperative pancreatic fistulaPOPFsurvivaloverall survivalpancreatic cancerpancreatectomyNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENCancers, Vol 13, Iss 5803, p 5803 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	postoperative pancreatic fistula POPF survival overall survival pancreatic cancer pancreatectomy Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	postoperative pancreatic fistula POPF survival overall survival pancreatic cancer pancreatectomy Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Andrea Grego Alberto Friziero Simone Serafini Amanda Belluzzi Lucia Moletta Luca Maria Saadeh Cosimo Sperti Does Pancreatic Fistula Affect Long-Term Survival after Resection for Pancreatic Cancer? A Systematic Review and Meta-Analysis
description	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, <i>p</i> = 0.0025), and a worse OS in patients with POPF, CR-POPF (HR 1.15, <i>p</i> = 0.0043), grade-C POPF (HR 2.21, <i>p</i> = 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.
format	article
author	Andrea Grego Alberto Friziero Simone Serafini Amanda Belluzzi Lucia Moletta Luca Maria Saadeh Cosimo Sperti
author_facet	Andrea Grego Alberto Friziero Simone Serafini Amanda Belluzzi Lucia Moletta Luca Maria Saadeh Cosimo Sperti
author_sort	Andrea Grego
title	Does Pancreatic Fistula Affect Long-Term Survival after Resection for Pancreatic Cancer? A Systematic Review and Meta-Analysis
title_short	Does Pancreatic Fistula Affect Long-Term Survival after Resection for Pancreatic Cancer? A Systematic Review and Meta-Analysis
title_full	Does Pancreatic Fistula Affect Long-Term Survival after Resection for Pancreatic Cancer? A Systematic Review and Meta-Analysis
title_fullStr	Does Pancreatic Fistula Affect Long-Term Survival after Resection for Pancreatic Cancer? A Systematic Review and Meta-Analysis
title_full_unstemmed	Does Pancreatic Fistula Affect Long-Term Survival after Resection for Pancreatic Cancer? A Systematic Review and Meta-Analysis
title_sort	does pancreatic fistula affect long-term survival after resection for pancreatic cancer? a systematic review and meta-analysis
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/a08b51c7c2634147b875558c28eb686d
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Does Pancreatic Fistula Affect Long-Term Survival after Resection for Pancreatic Cancer? A Systematic Review and Meta-Analysis

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