International journal of surgery (London, England) · 2025
The role of surgical resection, locoregional liver-directed treatments, and continuous systemic treatment in patients with liver metastatic pancreatic cancers.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Li Xiang, Qiao Guoliang, Chen Yiwen, Gao Fan, Zhang Xiaochen, Xiao Wenbo, Sun Ke, Sun Xiaoli, Bai Xueli, Liang Tingbo
Аннотация
BACKGROUND: No consistent clinical criteria and multimodal approaches to manage liver metastatic pancreatic cancer patients after effective systemic treatment have been developed. This study aims to assess the efficacy of surgical resection, liver-directed local therapy, or continuous systemic treatment in liver metastatic pancreatic cancer patients with favorable systemic treatment response.
MATERIALS AND METHODS: It was a retrospective observational study on 360 patients with liver metastatic pancreatic cancer. Patients were divided into four groups according to the treatment methods they received: surgery with/without liver-directed local therapy; non-surgery with/without liver-directed local therapy. Their overall survival (OS) and progression-free survival (PFS) were compared.
RESULTS: Forty-eight patients underwent surgery after systemic treatment. Patients who underwent surgery with liver-directed local therapy had superior outcomes than those who had only surgery without liver-directed local therapy (median OS: 47.2 vs. 18.3 months, P = 0.035; median PFS: 28.5 vs. 12.1 months, P = 0.017) and nonsurgical treatment (median OS: 47.2 vs. 19.1 months, P = 0.001; median PFS: 28.5 vs. 10.2 months, P = 0.002). Patients who underwent surgery without liver-directed local therapy had a similar prognosis as those with nonsurgical treatment. The OS of the non-surgery with liver-directed local therapy group was not significantly different from that of the non-surgery without liver-directed local therapy group (median OS: 19.0 vs. 11.5 months, P = 0.302). However, the PFS of the former was significantly superior to that of the latter (median PFS: 13.9 vs. 8.2 months, P = 0.037).
CONCLUSION: Surgical resection with liver-directed local therapy is the best approach to improve outcomes for liver metastatic pancreatic cancer patients after systemic treatment. Resection of the primary tumor or liver-directed local therapy alone, compared to continuous systemic treatment, failed to extend liver metastatic pancreatic cancer patient survival.
MATERIALS AND METHODS: It was a retrospective observational study on 360 patients with liver metastatic pancreatic cancer. Patients were divided into four groups according to the treatment methods they received: surgery with/without liver-directed local therapy; non-surgery with/without liver-directed local therapy. Their overall survival (OS) and progression-free survival (PFS) were compared.
RESULTS: Forty-eight patients underwent surgery after systemic treatment. Patients who underwent surgery with liver-directed local therapy had superior outcomes than those who had only surgery without liver-directed local therapy (median OS: 47.2 vs. 18.3 months, P = 0.035; median PFS: 28.5 vs. 12.1 months, P = 0.017) and nonsurgical treatment (median OS: 47.2 vs. 19.1 months, P = 0.001; median PFS: 28.5 vs. 10.2 months, P = 0.002). Patients who underwent surgery without liver-directed local therapy had a similar prognosis as those with nonsurgical treatment. The OS of the non-surgery with liver-directed local therapy group was not significantly different from that of the non-surgery without liver-directed local therapy group (median OS: 19.0 vs. 11.5 months, P = 0.302). However, the PFS of the former was significantly superior to that of the latter (median PFS: 13.9 vs. 8.2 months, P = 0.037).
CONCLUSION: Surgical resection with liver-directed local therapy is the best approach to improve outcomes for liver metastatic pancreatic cancer patients after systemic treatment. Resection of the primary tumor or liver-directed local therapy alone, compared to continuous systemic treatment, failed to extend liver metastatic pancreatic cancer patient survival.