ヒグチ　リヨウタ   HIGUCHI Ryota   樋口　亮太    所属   医学部 医学科（附属八千代医療センター）    職種   講師
論文種別	原著
言語種別	英語
査読の有無	査読なし
表題	Limited resection vs. pancreaticoduodenectomy for primary duodenal adenocarcinoma: a systematic review and meta-analysis.
掲載誌名	正式名：International journal of clinical oncology 略　 称：Int J Clin Oncol ISSNコード：14377772/13419625
掲載区分	国内
巻・号・頁	26(3),pp.450-460
著者・共著者	Burasakarn Pipit, Higuchi Ryota, Nunobe Souya, Kanaji Shingo, Eguchi Hidetoshi, Okada Ken-Ichi, Fujii Tsutomu, Nagakawa Yuichi, Kanetaka Kengo, Yamashita Hiroharu, Yamada Suguru, Kuroda Shinji, Aoyama Toru, Akahori Takahiro, Nakagawa Kenji, Yamamoto Masakazu, Yamaue Hiroki, Sho Masayuki, Kodera Yasuhiro,
担当区分	2nd著者
発行年月	2021/03
概要	It is well known that surgery is the mainstay treatment for duodenal adenocarcinoma. However, the optimal extent of surgery is still under debate. We aimed to systematically review and perform a meta-analysis of limited resection (LR) and pancreatoduodenectomy for patients with duodenal adenocarcinoma. A systematic electronic database search of the literature was performed using PubMed and the Cochrane Library. All studies comparing LR and pancreatoduodenectomy for patients with duodenal adenocarcinoma were selected. Long-term overall survival was considered as the primary outcome, and perioperative morbidity and mortality as the secondary outcomes. Fifteen studies with a total of 3166 patients were analyzed; 995 and 1498 patients were treated with limited resection and pancreatoduodenectomy, respectively. Eight and 7 studies scored a low and intermediate risk of publication bias, respectively. The LR group had a more favorable result than the pancreatoduodenectomy group in overall morbidity (odd ratio [OR]: 0.33, 95% confidence interval [CI] 0.17-0.65) and postoperative pancreatic fistula (OR: 0.13, 95% CI 0.04-0.43). Mortality (OR: 0.96, 95% CI 0.70-1.33) and overall survival (OR: 0.61, 95% CI 0.33-1.13) were not significantly different between the two groups, although comparison of the two groups stratified by prognostic factors, such as T categories, was not possible due to a lack of detailed data. LR showed long-term outcomes equivalent to those of pancreatoduodenectomy, while the perioperative morbidity rates were lower. LR could be an option for selected duodenal adenocarcinoma patients with appropriate location or depth of invasion, although further studies are required.
DOI	10.1007/s10147-020-01840-5
PMID	33386555