Impact of tumor size on survival outcome of pancreatic carcinoma following pancreatic resection: A systematic review and meta-analysis
DOI:
https://doi.org/10.3126/ajms.v9i1.18714Keywords:
Tumor size, Pancreatic cancer, Pancreaticoduodenectomy, Survival outcomeAbstract
The aim of the study was to evaluate the influence of tumor size on long-term survival outcome of pancreatic tumors following pancreatic resection and the possibility of implementing another tumor size cut-off point in AJCC pancreatic tumor staging. Literature searches was conducted on electronic database to identify relevant studies on tumor size related survival outcome following pancreatic resection for pancreatic adenocarcinoma. Meta-analysis was done using the effect estimates and the use of 95% confidence intervals (CIs) was done to calculate the pooled risk estimates; heterogeneity among studies was examined using I2 statistic. Total of 18 trials (13 retrospective and 5 prospective studies) including 6230 elderly patients was included in this study. The pooled HR of the tumor size with 2 cm cut-off was 1.43 with 95% CI of [1.27-1.62], I2= 17%, p<0.00001 and was statistically significant. Median survival for tumor size <2, >2, <3, >3, <4 and >4 were 41.02 months, 16.20 months, 19.41 months, 10.79 months, 24.2 months and 15.14 months respectively and the 1-, 3-, and 5-year survival rate decreased with increasing tumor diameter. Importantly, a total of four studies results indicated that 3-year survival rate and a total of five studies results indicated that 5-year survival rate had statistical significance with 3 cm cut-off. Tumor diameter of 2 cm seems to be a reasonable but relatively less comprehensive cut-off point. 3 cm cut-off maybe become a new potential tumor size cut-off point in addition to the current sole 2 cm cut-off point defining tumor stage.
Asian Journal of Medical Sciences Vol.9(1) 2018 1-10
Downloads
Downloads
Published
How to Cite
Issue
Section
License
Authors who publish with this journal agree to the following terms:
- The journal holds copyright and publishes the work under a Creative Commons CC-BY-NC license that permits use, distribution and reprduction in any medium, provided the original work is properly cited and is not used for commercial purposes. The journal should be recognised as the original publisher of this work.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).