| Objective:Pancreatic carcinoma remains a king of malignant tumor with a poor prognosis and high mortality despite advances in surgery and systemic therapies.Recent years have seen neoadjuvant therapy(NAT)appears on many studies,and increasing utilization of NAT on resectable,borderline resectable,locally advanced pancreatic cancer.The meta-analysis aims to clarify the benefits on prognosis of pancreatic carcinoma patients who applied NAT.Methods:Pubmed,MEDLIN,Wanfang database,Wipp database,CNKI(china national knowledge infrastructure)were searched for studies reporting median overall survival,R0 resection rate,pathological lymph node rate,postoperative hemorrhage,pancreatic leak in patients with Pancreatic carcinoma with or without NAT.Results:A total of 36 studies were identified that analysed the effect of NAT in pancreatic cancer.17 studies were included with 9875 patients in the final data synthesis.Meta-analysis suggested beneficial effects of NAT with increased R0 resection rate compared to surgery first approach,OR 3.4(95% CI 1.89,6.12).In addition,pancreatic leak rate were significantly lower in patients receiving NAT,OR 0.64(95% CI 0.43,0.94).Another studies indicated that postoperative hemorrhage and pathological lymph node rate were lower for patients receiving NAT.Also some studies indicated that median overall survival were prolonged comparing to surgery first.Conclusion:Current evidence suggests that neoadjuvant therapy has a beneficial effect on prognosis improvement comparing to surgery first strategy in patients with pancreatic carcinoma. |
