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Meta-Analysis
. 2013 Dec 10:11:311.
doi: 10.1186/1477-7819-11-311.

Meta-analysis of the efficacy of pancreatoduodenectomy with extended lymphadenectomy in the treatment of pancreatic cancer

Xinbao Xu  1 , Hui Zhang, Ping Zhou, Lei Chen
Affiliations
Meta-Analysis

Meta-analysis of the efficacy of pancreatoduodenectomy with extended lymphadenectomy in the treatment of pancreatic cancer

Xinbao Xu et al. World J Surg Oncol. .

Retraction in

Abstract

Background: The purpose of this meta-analysis is to compare the efficacy of pancreatoduodenectomy (PD) with extended lymphadenectomy (PD/ELND) versus standard PD in the treatment of pancreatic cancer, with the hope of providing evidence for clinical practice.

Methods: The retrieval of relevant literature published before September 2012 was carried out on PubMed, Medline, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL) by computer. Information was extracted according to Cochrane systematic review methods, and analyzed using software Stata 11.0.

Results: Five prospective randomized controlled trials (RCTs) were included in this meta-analysis of 555 cases (278 in the PD/ELND group and 277 in the standard PD group). The PD/ELND group showed a significantly lower 3-year survival rate (relative risk (RR) = 1.46, 95% confidence interval (CI) 1.03 to approximately 2.06, P = 0.034), prolonged operative time (weighted mean difference WMD = -1.03, 95% CI -1.96 to approximately -0.10, P = 0.029) and higher incidence of postoperative complications (RR = 0.56, 95% CI 0.42 to approximately 0.77, P = 0.000) by comparing with standard PD group. Besides, no significant difference was observed in the 1-year survival rate (RR = 0.87, 95% CI 0.60 to approximately 1.25, P = 0.69), 5-year survival rate (RR = 1.04, 95% CI 0.68 to approximately 1.58, P = 0.854), postoperative mortality (RR = 1.14, 95% CI 0.43 to approximately 3.00, P = 0.789), length of stay (WMD = -0.32, 95% CI -2.57 to approximately 1.94 , P = 0.784) and the amount of blood transfusions (WMD = -0.14, 95% CI -0.36 to approximately 0.08, P = 0.213).

Conclusions: PD/ELND does not have an advantage over standard PD in the survival rate for patients with pancreatic cancer, but does increase operative time and incidences of postoperative complications.

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Figures

Figure 1
Figure 1
Forest plot for the 1-year survival rate between the pancreatoduodenectomy with extended lymphadenectomy (PD/ELND) group and the standard pancreatoduodenectomy (PD) group. On the left, the name of the first author of the study is followed by the publication year. The size of the black box corresponding to each study is proportional to the sample size, and the horizontal line shows the corresponding 95% CI of the relative risk (RR) displayed on the right.
Figure 2
Figure 2
Forest plot for the 3-year survival rate between the pancreatoduodenectomy with extended lymphadenectomy (PD/ELND) group and the standard pancreatoduodenectomy (PD) group. The size of the black box corresponding to each study is proportional to the sample size, and the horizontal line shows the corresponding 95% CI of the relative risk (RR) displayed on the right.
Figure 3
Figure 3
Forest plot for the 5-year survival rate between the pancreatoduodenectomy with extended lymphadenectomy (PD/ELND) group and the standard pancreatoduodenectomy (PD) group. The size of the black box corresponding to each study is proportional to the sample size, and the horizontal line shows the corresponding 95% CI of the relative risk (RR) displayed on the right.
Figure 4
Figure 4
Forest plot for the incidence of postoperative complications between the pancreatoduodenectomy with extended lymphadenectomy (PD/ELND) group and the standard pancreatoduodenectomy (PD) group. The size of the black box corresponding to each study is proportional to the sample size, and the horizontal line shows the corresponding 95% CI of the relative risk (RR) displayed on the right.
Figure 5
Figure 5
Forest plot for the postoperative mortality between the pancreatoduodenectomy with extended lymphadenectomy (PD/ELND) group and the standard pancreatoduodenectomy (PD) group. The size of the black box corresponding to each study is proportional to the sample size, and the horizontal line shows the corresponding 95% CI of the relative risk (RR) displayed on the right.
Figure 6
Figure 6
Forest plot for the operative time between the pancreatoduodenectomy with extended lymphadenectomy (PD/ELND) group and the standard pancreatoduodenectomy (PD) group. The size of the black box corresponding to each study is proportional to the sample size, and the horizontal line shows the corresponding 95% CI of the relative risk (RR) displayed on the right.
Figure 7
Figure 7
Forest plot for the amount of blood transfusions between the pancreatoduodenectomy with extended lymphadenectomy (PD/ELND) group and the standard pancreatoduodenectomy PD group. The size of the black box corresponding to each study is proportional to the sample size, and the horizontal line shows the corresponding 95% CI of the relative risk (RR) displayed on the right.
Figure 8
Figure 8
Forest plot for hospital stays between the pancreatoduodenectomy with extended lymphadenectomy (PD/ELND) group and the standard pancreatoduodenectomy (PD) group. The size of the black box corresponding to each study is proportional to the sample size, and the horizontal line shows the corresponding 95% CI of the relative risk (RR) displayed on the right.
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