Table 3.
Characteristics of patients with mPDAC undergoing surgery after initial chemotherapy.
| References | Patients, N | Definition of Oligometastatic Disease or Inclusion Criteria for Surgery after IC | Patients Undergoing Surgery after IC, N (%) | Type of IC in Patients Undergoing Surgery, N (%) | Median Interval last IC-Surgery, Months (range) | Main Metastatic Localisation | Type of Surgery for Primary Lesion, N | Type of Surgery for Liver Metastases N | Adjuvant CT N (%) | 30 Day Mortality N (%) | OS Months (Range) | |||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Liver, N | Lung, N | Lymphnodes, N | Peritoneum, N | |||||||||||
| Frigerio [24] | 535 | Disappearance of liver metastasis on radiological examination | 24 (4) | FOLFIRINOX N 16 (66), GEM N 5 (21), Gemcitabine + Nab-Paclitaxel N 3 (13) | 2 (2–16) *** | 24 | 0 | 0 | 0 | PD N 14 DP N 10 |
None | N 15 (63) | Not specified | 56 (36–75) ** |
| Crippa [25] | 127 | Single metastasis remaining after initial chemotherapy | 11 (8) | FOLFIRINOX N3 (27), GEMOX N2 (2), PDXG N1 (9), PEFG N1 (9), PEXG N4 (36) | 12 (6–20) *** | 11 | 0 | 0 | 0 | PD N 6 DP N 5 |
Atypical resection N 1, Segmentectomy N 2 | Not specified | Not specified | 39 * |
| Tanaka [26] | 101 | Maximum of six metastatic lesions. | 43 (42) | FOLFIRINOX N43 (100) | Not specified | 30 | 1 | 3 | 7 | PD N 16 DP N 19 TP N 8 |
Not specified | N 4 (9), Unknown 9 (21) | 1 (2) | 21.9 (12.7–20.5) *** |
| Kandel [27] | 42 | ≤2 metastatic tumors total in liver or lung, each <4 cm | 6 (14) | Not specified | Not specified | 4 | 0 | 0 | 2 | PD N 4 DP N 2 |
Hepatic resection N1, Hepatic resection and RFA n 2, Radioembolization N 1 | 6 (100) | 0 | 32/4 (1.4–44.28) ** |
| Wright [28] | 1147 | Not specified | 23 (2) | FOLFIRINOX N14 (60.9), Gemcitabine based regimens N 9 (39.1) | 9.7 (5.8–12.8) *** | 16 | 6 | 0 | 2 | PD 15 DP 8 |
Metastasectomy N 9 | Not specified | 0 | 18.2 (11.8–35.5) *** |
| Byun [29] | 135 | Single metastatic lesion or resectable lesion | 8 (5) | FOLFIRINOX 8 (100) | Not specified | NS | NS | NS | NS | Not specified | Not specified | Not specified | Not specified | 32 * |
Values are * mean, ** mean (s.d.), *** median (range). IC: initial chemotherapy; CT: chemotherapy; PD: pancreaticoduodenectomy; DP: distal pancreasectomy; TP: total pancreatectomy; GEM: gemcitabine; GEMOX: gemcitabine and oxaliplatin; FOLFIRINOX: oxaliplatin, irinotecan, fluorouracil and leucovorin; PEXG/PDXG: cisplatin, capecitabine, gemcitabine plus either epirubicin (PEXG) or docetaxel (PDXG); PEFG: cisplatin, epirubicin, fluorouracil and gemcitabine. NS: not specified.