Meta-analysis of Long-term Survival of Extended and Standard Pancreaticoduodenectomy for Carcinoma of Head of Pancreas with Positive Lymph Nodes

Objective To compare the long-term survival of standard and extended pancreaticoduodenectomy(PD) for the patients with carcinoma of the head of pancreas with positive lymph nodes by Meta-analysis.

Methods A literature search of PubMed,Embase,Medline,Cochrane library and CBMDisc from January 1990 to October 2015 was performed. Systems analysis was proceeded by RevMa5.2 software.

Results Five RCT studies of six articles were involved. Extended pancreaticoduodenectomy (EPD) acquired more lymph nodes than standard pancreaticoduodenectomy (SPD). For the patients with positive lymph nodes,EPD prolonged the postoperative 5-year survival rate (RR: 2.27,95%CI: 1.08-4.79,P=0.03) ,but there was no difference with SPD in 1- and 3-year survival rates.

Conclusion  EPD may prolong the long-term survival rate of the patients with lymph positive pancreatic head carcinoma. EPD is unnecessary if there is no evidence of lymphatic metastasis.