Pancreatectomy combined with superior mesenteric vein-portal vein resection for pancreatic cancer: a meta-analysis

Abstract

Background: Pancreatectomy combined with superior mesenteric vein-portal vein resection (VR) for pancreatic cancer remains a matter of debate. The present study is a meta-analysis of the available evidence.

Methods: Articles published until end of March 2011, comparing the results of pancreatic resections with VR versus without VR, were searched. Pooled odds ratios (OR) and weighted mean differences (WMD; with 95% Confidence Intervals [95% CI]) were calculated using either the fixed effects model or the random effects model.

Results: Nineteen nonrandomized studies met the inclusion criteria, comprising 2,247 patients. There was no difference in perioperative morbidity (OR: 0.95; 95% CI: 0.74-1.21; P = 0.67), mortality (OR: 1.19; 95% CI: 0.73-1.96; P = 0.48), or 5-year overall survival (OR: 0.57; 95% CI: 0.32-1.02; P = 0.06) between patients with VR and those without VR.

Conclusions: Pancreatectomy combined with VR resection for pancreatic cancer is justified because it can result in good perioperative outcome and long-term survival comparable to that obtained with standard resection. Owing to the selection bias and low level of clinical evidence available so far, the results should be interpreted with caution.