Complete oncological resection of pancreatic cancer remains the cornerstone in treatment of pancreatic cancer. Anatomical relations to major vessels continue to play an ongoing important role in the decision-making regarding treatment options in pancreatic cancer. Despite concomitant venous resections being routinely performed in major centers, arterial resections remain controversial. The aim of this study was to compare the short- and long-term outcomes of pancreatic cancer surgery with concomitant arterial resections to standard non-arterial resections from modern studies. We included studies comparing pancreatic cancer surgery with arterial resections to standard non-arterial surgery for pancreatic cancer published from 2018 to 2024. A total of seven articles involving 5465 patients met the inclusion criteria and were included for analysis. Arterial resections are associated with a greater risk of mortality compared to standard resections (Risk ratio (RR): 3.28; 95% confidence interval (CI) [0.75–14.46];p= 0.0365). There were no significant differences in overall morbidity (RR: 1.48; 95% CI [1.16–1.89];p= 0.2923) or serious complications (Mean Difference (MD): 2.6; 95% CI: [−21.52–16.32];p= 0.738). Arterial resections were associated with a 3.1-fold increased chance of R0 resection (RR: 3.11; 95% CI [1.65–5.86];p< 0.0227). Arterial resection in pancreatic cancer continues to be associated with an increased risk of mortality; however, recent studies show no significant increase in morbidity whilst significantly increasing R0 resections.
胰腺癌的完全肿瘤学切除仍是其治疗的基石。肿瘤与主要血管的解剖关系在胰腺癌治疗方案决策中持续发挥重要作用。尽管主要医疗中心已常规开展联合静脉切除术，但动脉切除术仍存在争议。本研究旨在通过现代研究比较胰腺癌手术联合动脉切除术与标准非动脉切除术的短期及长期疗效。我们纳入了2018年至2024年间发表的比较胰腺癌动脉切除术与标准非动脉手术的研究文献。共7篇涉及5465名患者的文章符合纳入标准并进入分析。与标准切除术相比，动脉切除术具有更高的死亡风险（风险比（RR）：3.28；95%置信区间（CI）[0.75–14.46]；p=0.0365）。总体并发症发生率（RR：1.48；95% CI [1.16–1.89]；p=0.2923）或严重并发症（平均差（MD）：2.6；95% CI：[−21.52–16.32]；p=0.738）均无显著差异。动脉切除术使R0切除率提高3.1倍（RR：3.11；95% CI [1.65–5.86]；p<0.0227）。胰腺癌动脉切除术仍与死亡风险增加相关；然而近期研究表明，该术式在显著提高R0切除率的同时，并未显著增加并发症发生率。
Arterial Resections in Pancreatic Cancer—An Updated Systematic Review and Meta-Analysis
肿瘤(癌症)患者之家