Radical resection benefits patients suffering pancreatic ductal adenocarcinoma with liver oligometastases

Purpose: Whether patients suffering liver oligometastases from pancreatic ductal adenocarcinoma (LOPDA) should undergo surgical treatment remains controversial. Methods: PubMed and Embase databases were systematically reviewed until 2023 June. Survival data were collected from the Kaplan -Meier curves. Safety and survival were evaluated using primary outcomes such as 1 -year, 3 -year, and 5 -year survival rates, and 30 -day mortality and morbidity. A subgroup meta -analysis was conducted to compare survival rates post -synchronous resection and resection post-neoadjuvant chemotherapy in LOPDA. Results: Our analysis of 15 studies involving 1,818 patients (surgical group, 648 and nonsurgical group, 1,170) indicates that radical hepatectomy for LOPDA notably improved 1 -year (odds ratio [OR], 3.24; 95% confidence interval [CI], 2.45-4.28; P < 0.001), 3 -year (OR, 5.74; 95% CI, 3.36-8.90; P < 0.001), and 5 -year (OR, 4.89; 95% CI, 2.56-9.35; P < 0.001) overall survival (OS) rates. A separate analysis of 6 studies with 750 patients demonstrated the safety of LOPDA surgery, with no increase in postoperative complications (P = 0.26 for overall morbidity and P = 0.99 for mortality) compared to the patients with no metastatic disease from the pancreatic ductal adenocarcinoma (NMPDA) group. The NMPDA group showed superior 1 -year and 3 -year OS rates, but not 5 -year OS rates compared to the LOPDA group.<br /> Conclusion: Surgical treatment apparently offers a survival advantage to LOPDA by comparing with nonsurgical groups in 1-, 3-, and 5 -year OS rates. Radical resection for LOPDA is a safe treatment without more postoperative complications than NMPDA.