Is Complete Pathologic Response in Pancreatic Cancer Overestimated? A Systematic Review of Prospective Studies
- PDF / 1,193,830 Bytes
- 13 Pages / 595.276 x 790.866 pts Page_size
- 105 Downloads / 174 Views
REVIEW ARTICLE
Is Complete Pathologic Response in Pancreatic Cancer Overestimated? A Systematic Review of Prospective Studies Antolino Laura 1 & Crovetto Anna 1 & Matteo Cinquepalmi 1 & Moschetta Giovanni 1 & Mattei Maria Sole 1 & Andrea Kazemi Nava 2 & Petrucciani Niccolò 1 & Nigri Giuseppe 1 & Valabrega Stefano 1 & Aurello Paolo 1 & D’Angelo Francesco 1 & Ramacciato Giovanni 1 Received: 18 December 2019 / Accepted: 11 June 2020 # 2020 The Society for Surgery of the Alimentary Tract
Abstract Background In literature, percentages of pathologic complete response (pCR) in patients presenting with resectable (RES), borderline resectable (BLR) or locally advanced (LA) pancreatic cancer (PaC) after neoadjuvant treatment (NADT) are variable, ranging 0–33%. Those data come mostly from retrospective reviews of single centres. The objective of this systematic review is to assess the incidence of pCR. Methods Following the criteria of the PRISMA statement, a literature search was conducted looking for prospective papers focusing on neoadjuvant treatment in PaC. Retrospective papers, other than ductal carcinoma histologies and trials including metastatic patients, were excluded from the present review. Data extraction was carried out by 3 independent investigators. Metaanalysis was performed with ProMeta3 Software (Internovi, 2015). PROSPERO registry: CRD42018095641. Results The literature search of Embase, Cochrane and Medline with the terms “neoadjuvant OR preoperative”, “pancreatic OR pancreas” and “cancer OR adenocarcinoma OR tumor” led to the identification of 3128 papers. We restricted the search to humans, last 10 years and English language articles resulting in 1158 eligible articles to review. Extended paper revision led to the inclusion of 27 papers. Complete pathologic response ranged 0–11.11%, at the meta-analysis 4% (95% CI 3–5%), in prospective studies 0–9.09% and in prospective databases 1.63–11.11%. Conclusions Pathologic complete response in pancreatic cancer is actually infrequent: high-quality studies provide a more reliable picture of neoadjuvant effects, high rates of pCR are reported in selected retrospective studies but it is overestimated. Keywords Pancreatic cancer . Complete pathologic response . Pancreatic surgery . Neoadjuvant
Introduction Ductal adenocarcinoma of the pancreas (PaC) is one of the deadliest forms of cancer, and its incidence has risen, with an Electronic supplementary material The online version of this article (https://doi.org/10.1007/s11605-020-04697-1) contains supplementary material, which is available to authorized users. * Matteo Cinquepalmi [email protected] 1
General Surgery Unit, Department of Medical and Surgical Sciences and Translational Medicine, St. Andrea University Hospital, Sapienza University of Rome, Via di Grottorassa 1035, 00168 Rome, Italy
2
Hepatopancreaticobiliary Group, Saint Vincent’s University Hospital, Dublin, Ireland
average annual percentage change of 0.9 and 1.0% between 2005 and 2014 in men and women respectively.1 The only curati
Data Loading...
