SynthesisJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2015
Extended Versus Standard Lymphadenectomy for Pancreatic Head Cancer: Meta-Analysis of Randomized Controlled Trials.
Synthesis in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
30 citing papers in PubMed, 1 synthesis or guideline pooled it, 64 citations in OpenAlex.
- Extended lymph node resection versus standard resection for pancreatic and periampullary adenocarcinoma.The Cochrane database of systematic reviews · 2021Pooled it
- Pancreatic ductal adenocarcinoma and pancreatic surgery in the 21st century: triumphs, turning points, and unresolved challenges.Updates in surgery · 2026Review
- A nomogram based on dual-layer detector spectral computed tomography quantitative parameters and morphological quantitative indicator for distinguishing metastatic and nonmetastatic regional lymph nodes in pancreatic ductal adenocarcinoma.Quantitative imaging in medicine and surgery · 2024Article
- Comprehensive multimodal management of borderline resectable pancreatic cancer: Current status and progress.World journal of gastrointestinal surgery · 2023Review
- Surgical management of pancreatic ductal adenocarcinoma: a narrative review.Translational gastroenterology and hepatology · 2023Review
- Clinical value of extended lymphadenectomy in radical surgery for pancreatic head carcinoma at different T stages.World journal of gastrointestinal surgery · 2022Article
- Importance of an appropriate number of examined lymph nodes in patients with pancreatic cancer-the more the better?Hepatobiliary surgery and nutrition · 2022Article
- Technical progress in robotic pancreatoduodenectomy: TRIANGLE and periadventitial dissection for retropancreatic nerve plexus resection.Langenbeck's archives of surgery · 2021Article
- [Surgery for periampullary pancreatic cancer].Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen · 2021Review
- Review
- The Current Treatment Paradigm for Pancreatic Ductal Adenocarcinoma and Barriers to Therapeutic Efficacy.Frontiers in oncology · 2021Review
- Neoadjuvant chemotherapy followed by total pancreatectomy with splenectomy and combined vascular resections after preoperative percutaneous transhepatic portal vein stent placement in locally advanced pancreatic cancer with portal vein total obliteration.Annals of hepato-biliary-pancreatic surgery · 2020Article
- Multidisciplinary consensus statement on the clinical management of patients with pancreatic cancer.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2020Article
- [Surgery of pancreatic cancer: techniques to avoid local recurrence].Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen · 2020Review
- Review
- Survival outcomes of pancreaticoduodenectomy versus extended pancreaticoduodenectomy procedure for pancreatic head carcinoma: a propensity score matching study.Translational cancer research · 2020Article
- Local radicality and survival outcome of pancreatic cancer surgery.Annals of gastroenterological surgery · 2019Review
- Management of pancreatic head adenocarcinoma: From where to where?World journal of gastrointestinal surgery · 2019Review
- Optimizing the outcomes of pancreatic cancer surgery.Nature reviews. Clinical oncology · 2019Review
- Prognostic value of the metastatic lymph node ratio in patients with pancreatic cancer.International journal of clinical and experimental pathology · 2019Article
Corrections and comments
- Commented on by
Authors and funding
10 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionThe evidence for improved prognostic assessment and long-term survival for extended pancreatoduodenectomy (EPD) compared to standard pancreatoduodenectomy (SPD) in patients with carcinoma of the head of the pancreas has not been considered from only randomized controlled trials (RCTs).
methodsThe aim of this study was to conduct a systematic review and meta-analysis of the outcomes comparing SPD and EPD in RCTs. Searches were performed on MEDLINE, Embase and Cochrane databases using MeSH keyword combinations: 'pancreatic cancer', 'pancreaticoduodenectomy', 'extended', 'randomized' and 'lymphadenectomy'. RCTs published up to 2014 were included. Overall post-operative survival, morbidity, 30-day mortality and length of hospital stay were the outcomes assessed.
resultsFive eligible RCTs with 546 participants were included (EPD = 276 and SPD = 270). EPD was associated with a significantly higher number of excised lymph nodes (LNs) compared to SPD (mean difference = 15.73, 95% confidence interval (CI) = 9.41-22.04; P < 0.00001; I(2) = 88%). LN metastasis was detected in 58-68 and 55-70% of patients who had EPD and SPD, respectively. EPD did not improve overall survival (hazard ratio (HR) = 0.88, 95% CI = 0.75-1.03; P = 0.11) but did worsen post-operative morbidity compared to SPD (risk ratio (RR) = 1.23; 95% CI = 1.01-1.50; P = 0.004; I(2) = 9%). There were no differences in the 30-day mortality (RR = 0.81; 95% CI = 0.32-2.06; P = 0.66; I(2) = 0%) or length of hospital stay (mean difference = 1.39, 95% CI = -2.31 to 5.09; P = 0.46; I(2) = 67%).
conclusionSPD is associated with reduced morbidity, but equivalent long-term benefits compared to patients undergoing EPD.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.