TY - JOUR
T1 - Systematic review on the treatment of isolated local recurrence of pancreatic cancer after surgery; re-resection, chemoradiotherapy and SBRT
AU - Groot, Vincent P.
AU - van Santvoort, Hjalmar C.
AU - Rombouts, Steffi J.E.
AU - Hagendoorn, Jeroen
AU - Borel Rinkes, Inne H.M.
AU - van Vulpen, Marco
AU - Herman, Joseph M.
AU - Wolfgang, Christopher L.
AU - Besselink, Marc G.
AU - Molenaar, I. Quintus
N1 - Publisher Copyright:
© 2016 International Hepato-Pancreato-Biliary Association Inc.
PY - 2017/2/1
Y1 - 2017/2/1
N2 - Background The majority of patients who have undergone a pancreatic resection for pancreatic cancer develop disease recurrence within two years. In around 30% of these patients, isolated local recurrence (ILR) is found. The aim of this study was to systematically review treatment options for this subgroup of patients. Methods A systematic search was performed in PubMed, Embase and the Cochrane Library. Studies reporting on the treatment of ILR after initial curative-intent resection of primary pancreatic cancer were included. Primary endpoints were morbidity, mortality and survival after ILR treatment. Results After screening 1152 studies, 18 studies reporting on 313 patients undergoing treatment for ILR were included. Treatment options for ILR included surgical re-resection (8 studies, 100 patients), chemoradiotherapy (7 studies, 153 patients) and stereotactic body radiation therapy (SBRT) (4 studies, 60 patients). Morbidity and mortality were reported for re-resection (29% and 1%, respectively), chemoradiotherapy (54% and 0%) and SBRT (3% and 1%). Most patients had a prolonged disease-free interval before recurrence. Median survival after treatment of ILR of up to 32, 19 and 16 months was reported for re-resection, chemoradiotherapy and SBRT, respectively. Conclusion In selected patients, treatment of ILR following pancreatic resection for pancreatic cancer seems safe, feasible and associated with relatively good survival.
AB - Background The majority of patients who have undergone a pancreatic resection for pancreatic cancer develop disease recurrence within two years. In around 30% of these patients, isolated local recurrence (ILR) is found. The aim of this study was to systematically review treatment options for this subgroup of patients. Methods A systematic search was performed in PubMed, Embase and the Cochrane Library. Studies reporting on the treatment of ILR after initial curative-intent resection of primary pancreatic cancer were included. Primary endpoints were morbidity, mortality and survival after ILR treatment. Results After screening 1152 studies, 18 studies reporting on 313 patients undergoing treatment for ILR were included. Treatment options for ILR included surgical re-resection (8 studies, 100 patients), chemoradiotherapy (7 studies, 153 patients) and stereotactic body radiation therapy (SBRT) (4 studies, 60 patients). Morbidity and mortality were reported for re-resection (29% and 1%, respectively), chemoradiotherapy (54% and 0%) and SBRT (3% and 1%). Most patients had a prolonged disease-free interval before recurrence. Median survival after treatment of ILR of up to 32, 19 and 16 months was reported for re-resection, chemoradiotherapy and SBRT, respectively. Conclusion In selected patients, treatment of ILR following pancreatic resection for pancreatic cancer seems safe, feasible and associated with relatively good survival.
UR - http://www.scopus.com/inward/record.url?scp=85008441607&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85008441607&partnerID=8YFLogxK
U2 - 10.1016/j.hpb.2016.11.001
DO - 10.1016/j.hpb.2016.11.001
M3 - Review article
C2 - 28065427
AN - SCOPUS:85008441607
SN - 1365-182X
VL - 19
SP - 83
EP - 92
JO - HPB
JF - HPB
IS - 2
ER -