Synchronous surgery combined preoperative chemotherapy benefits patients suffering pancreatic ductal adenocarcinoma with liver metastases: a systematic review and meta-analysis

Abstract Recent studies have considered pancreatectomy combined with synchronous metastasectomy as a potential treatment option for patients with metastatic pancreatic ductal adenocarcinoma (PDAC). This study aimed to evaluate the role of surgery in PDAC patients with hepatic metastases and to ident...

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Main Authors: Pengcheng Zhao, Zihe Wang, Kang Xue, Xiaofeng Liu, Bole Tian
Format: Article
Language:English
Published: Nature Portfolio 2025-08-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-13811-9
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author Pengcheng Zhao
Zihe Wang
Kang Xue
Xiaofeng Liu
Bole Tian
author_facet Pengcheng Zhao
Zihe Wang
Kang Xue
Xiaofeng Liu
Bole Tian
author_sort Pengcheng Zhao
collection DOAJ
description Abstract Recent studies have considered pancreatectomy combined with synchronous metastasectomy as a potential treatment option for patients with metastatic pancreatic ductal adenocarcinoma (PDAC). This study aimed to evaluate the role of surgery in PDAC patients with hepatic metastases and to identify the prognostic factors. PubMed, Embase, and Cochrane Library databases were searched and the hazard ratio (HR) with 95% confidence interval (CI) was extracted from eligible studies. Pooled HR with 95% CI were used to reveal the association between synchronous surgery and overall survival (OS). Thirteen studies with 1107 patients were included. The results (pooled HR 0.496, 95% CI 0.414–0.594, I2 = 0, p = 0.531) indicated that simultaneous resection could prolong the survival of PDAC patients with hepatic metastases. Moreover, patients who underwent synchronous surgery plus preoperative chemotherapy had better OS than those who received synchronous surgery alone (HR 0.579, 95% CI 0.473–0.709, I2 = 0, p = 0.418). Preoperative chemotherapy, resection of the primary tumor, R0 resection margin status at pancreatic resection and postoperative chemotherapy were the prognostic factors in PDAC patients with liver metastasis. Synchronous resection of primary tumors and metastases could prolong the survival of PDAC patients with hepatic metastases, and adjuvant chemotherapy played a crucial role in the perioperative period of metastatic PDAC patients.
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spelling doaj-art-69f98c5bb8f3447581a684e22bbda0042025-08-20T03:42:36ZengNature PortfolioScientific Reports2045-23222025-08-0115111010.1038/s41598-025-13811-9Synchronous surgery combined preoperative chemotherapy benefits patients suffering pancreatic ductal adenocarcinoma with liver metastases: a systematic review and meta-analysisPengcheng Zhao0Zihe Wang1Kang Xue2Xiaofeng Liu3Bole Tian4Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second Hospital, Sichuan UniversityDepartment of General Surgery, Division of Pancreatic Surgery, West China Hospital, Sichuan UniversityDepartment of General Surgery, Division of Pancreatic Surgery, West China Hospital, Sichuan UniversityDepartment of General Surgery, Division of Pancreatic Surgery, West China Hospital, Sichuan UniversityDepartment of General Surgery, Division of Pancreatic Surgery, West China Hospital, Sichuan UniversityAbstract Recent studies have considered pancreatectomy combined with synchronous metastasectomy as a potential treatment option for patients with metastatic pancreatic ductal adenocarcinoma (PDAC). This study aimed to evaluate the role of surgery in PDAC patients with hepatic metastases and to identify the prognostic factors. PubMed, Embase, and Cochrane Library databases were searched and the hazard ratio (HR) with 95% confidence interval (CI) was extracted from eligible studies. Pooled HR with 95% CI were used to reveal the association between synchronous surgery and overall survival (OS). Thirteen studies with 1107 patients were included. The results (pooled HR 0.496, 95% CI 0.414–0.594, I2 = 0, p = 0.531) indicated that simultaneous resection could prolong the survival of PDAC patients with hepatic metastases. Moreover, patients who underwent synchronous surgery plus preoperative chemotherapy had better OS than those who received synchronous surgery alone (HR 0.579, 95% CI 0.473–0.709, I2 = 0, p = 0.418). Preoperative chemotherapy, resection of the primary tumor, R0 resection margin status at pancreatic resection and postoperative chemotherapy were the prognostic factors in PDAC patients with liver metastasis. Synchronous resection of primary tumors and metastases could prolong the survival of PDAC patients with hepatic metastases, and adjuvant chemotherapy played a crucial role in the perioperative period of metastatic PDAC patients.https://doi.org/10.1038/s41598-025-13811-9Pancreatic ductal adenocarcinomaLiver metastasesSynchronous resectionChemotherapyMeta-analysis
spellingShingle Pengcheng Zhao
Zihe Wang
Kang Xue
Xiaofeng Liu
Bole Tian
Synchronous surgery combined preoperative chemotherapy benefits patients suffering pancreatic ductal adenocarcinoma with liver metastases: a systematic review and meta-analysis
Scientific Reports
Pancreatic ductal adenocarcinoma
Liver metastases
Synchronous resection
Chemotherapy
Meta-analysis
title Synchronous surgery combined preoperative chemotherapy benefits patients suffering pancreatic ductal adenocarcinoma with liver metastases: a systematic review and meta-analysis
title_full Synchronous surgery combined preoperative chemotherapy benefits patients suffering pancreatic ductal adenocarcinoma with liver metastases: a systematic review and meta-analysis
title_fullStr Synchronous surgery combined preoperative chemotherapy benefits patients suffering pancreatic ductal adenocarcinoma with liver metastases: a systematic review and meta-analysis
title_full_unstemmed Synchronous surgery combined preoperative chemotherapy benefits patients suffering pancreatic ductal adenocarcinoma with liver metastases: a systematic review and meta-analysis
title_short Synchronous surgery combined preoperative chemotherapy benefits patients suffering pancreatic ductal adenocarcinoma with liver metastases: a systematic review and meta-analysis
title_sort synchronous surgery combined preoperative chemotherapy benefits patients suffering pancreatic ductal adenocarcinoma with liver metastases a systematic review and meta analysis
topic Pancreatic ductal adenocarcinoma
Liver metastases
Synchronous resection
Chemotherapy
Meta-analysis
url https://doi.org/10.1038/s41598-025-13811-9
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AT zihewang synchronoussurgerycombinedpreoperativechemotherapybenefitspatientssufferingpancreaticductaladenocarcinomawithlivermetastasesasystematicreviewandmetaanalysis
AT kangxue synchronoussurgerycombinedpreoperativechemotherapybenefitspatientssufferingpancreaticductaladenocarcinomawithlivermetastasesasystematicreviewandmetaanalysis
AT xiaofengliu synchronoussurgerycombinedpreoperativechemotherapybenefitspatientssufferingpancreaticductaladenocarcinomawithlivermetastasesasystematicreviewandmetaanalysis
AT boletian synchronoussurgerycombinedpreoperativechemotherapybenefitspatientssufferingpancreaticductaladenocarcinomawithlivermetastasesasystematicreviewandmetaanalysis