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Meta-Analysis
. 2025 Sep 10;410(1):269.
doi: 10.1007/s00423-025-03778-6.

Is there a chance for curative treatment for metastatic pancreatic adenocarcinoma? A systematic review with meta-analysis

Kellil Tarek  1 , Tormane Mohamed Amine  2 , Rhaiem Rami  3 , Amara Amal  2 , Gianpaoli Francesca  2 , Sanchez Stephane  4 , Piardi Tullio  2
Affiliations
Meta-Analysis

Is there a chance for curative treatment for metastatic pancreatic adenocarcinoma? A systematic review with meta-analysis

Kellil Tarek et al. Langenbecks Arch Surg. .

Abstract

Introduction: Pancreatic adenocarcinomas (PDAC) have a poor prognosis, with a 5-year relative Survival rate of 11.5%. Only 20% of patients are initially eligible for resection, and 50% of patients presented with metastatic disease, currently only candidates' palliative treatment. This meta-analysis compares the outcomes of surgical treatment versus chemotherapy or palliative care for M-PDAC.

Methods: A literature search was performed on May, 9th of 2024. A meta-analysis was then conducted. The primary outcome was Overall Survival and the secondary outcomes were 1-year Survival and 3-year survival. Subgroup analysis was also performed, based on metastatic sites.

Results: The analyses showed a significant benefit of surgical treatment in terms of overall survival (HR: 0.42, 95% CI [0.33- 0.53]), 1-year survival (OR: 0.37, CI 95% [0.26, 0.52]), and 3-year survival (OR: 0.16, CI 95% [0.07, 0.383]). In the subgroup analysis based on metastatic site, the benefit of surgical treatment persisted for liver-only metastases (HR : 0.40, CI 95% [0.29, 0.53]), but not for lung-only metastases.

Conclusion: This meta-analysis showed a survival advantage for surgical treatment in patients with M-PDAC and especially in liver-only metastases. Prospective trials are needed to confirm these findings and refine patient selection criteria for surgical treatment.

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Conflict of interest statement

Declarations. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA flow-chart of the bibliographic research
Fig. 2
Fig. 2
Forest plot overall survival
Fig. 3
Fig. 3
Overall survival: subgroup analysis based on metastatic site
Fig. 4
Fig. 4
Forest Plot of 1-year survival
Fig. 5
Fig. 5
1-year survival: subgroup analysis based on metastatic site
Fig. 6
Fig. 6
Forest plot of 3-year survival
Fig. 7
Fig. 7
3-year survival: subgroup analysis based on metastatic site
See this image and copyright information in PMC

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