Pancreatic, periampullary and biliary cancer with liver metastases: Should we consider resection in selected cases?  

作　　者：Rachael Chang Lee Harsh Kanhere Markus Trochsler Vy Broadbridge Guy Maddern Timothy J Price 

机构地区：[1]Department of Medical Oncology, the Queen Elizabeth Hospital,Adelaide 5011, Australia [2]Department of Surgery, the Queen Elizabeth Hospital,Adelaide 5011, Australia [3]School of Medicine, University of Adelaide

出　　处：《World Journal of Gastrointestinal Oncology》2018年第8期211-220,共10页世界胃肠肿瘤学杂志（英文版）（电子版）

摘　　要：AIM To analyse the safety and efficacy of curative intent surgery in biliary and pancreatic cancer.METHODS An extensive literature review was performed using MEDLINE, Google Scholar and EMBASE to identify articles regarding hepato-pancreatoduodenectomy or resection of liver metastasis in patients with pancreatic, biliary tract, periampullary and gallbladder cancers.RESULTS A total of 19 studies were identified and reviewed. Major hepatectomy was undertaken in 391 patients. The median overall survival for pancreatic cancer ranged from 5-36 mo and for biliary tract/gallbladder cancer, it was 8-38 mo. The 30 d mortality rate was only 1%-9%. Overall Survival was significantly better for patients, who had good response to neoadjuvant chemotherapy, underwent metachronous liver resection and who had intestinal type tumours.CONCLUSION Resection of liver metastases in pancreatic and biliary cancers may provide survival benefit without compromising safety and quality of life in a very select group of patients. These data may be utilised to formulate selection criteria that may allow future investigation of resection in the era of more effective systemic therapy.AIM To analyse the safety and efficacy of curative intent surgery in biliary and pancreatic cancer.METHODS An extensive literature review was performed using MEDLINE, Google Scholar and EMBASE to identify articles regarding hepato-pancreatoduodenectomy or resection of liver metastasis in patients with pancreatic, biliary tract, periampullary and gallbladder cancers.RESULTS A total of 19 studies were identified and reviewed. Major hepatectomy was undertaken in 391 patients. The median overall survival for pancreatic cancer ranged from 5-36 mo and for biliary tract/gallbladder cancer, it was 8-38 mo. The 30 d mortality rate was only 1%-9%. Overall Survival was significantly better for patients, who had good response to neoadjuvant chemotherapy, underwent metachronous liver resection and who had intestinal type tumours.CONCLUSION Resection of liver metastases in pancreatic and biliary cancers may provide survival benefit without compromising safety and quality of life in a very select group of patients. These data may be utilised to formulate selection criteria that may allow future investigation of resection in the era of more effective systemic therapy.

关 键 词：PANCREAS Liver RESECTION GALL BLADDER CHOLANGIOCARCINOMA Review 

分 类 号：R[医药卫生]