Pancreatectomy Combined with Superior Mesenteric Vein-Portal Vein Resection for Pancreatic Cancer: A Meta-analysis

Abstract

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. 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. 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. 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.