Introduction
Methods
Search strategy
Inclusion and exclusion criteria
Data collection
Reference | Year | Inclusion period | Sample size (AR/no AR) | AR neoadjuvant therapy (+/−) | Country | Follow-up (months) |
---|---|---|---|---|---|---|
Addeo et al. [14] | 2015 | 2007–2012 | 24/21 | 24/0 | USA/France | – |
Amano et al. [15] | 2015 | 2012–2013 | 13/0 | 13/0 | Japan | 14.5 |
Bachellier et al. [16] | 2018 | 1990–2017 | 118/0 | 89/29 | France | 15.77 |
Baumgartner et al. [17] | 2012 | 2007–2010 | 11/0 | 11/0 | USA | – |
Beane et al. [18] | 2015 | 2011–2012 | 20/172 | 3/17 | USA | – |
Cesaretti et al. [19] | 2016 | 1998–2015 | 5/0 | 5/0 | France | – |
Christians et al. [20] | 2014 | 2011–2013 | 10/0 | 10/0 | USA | 21 |
Del Chiaro et al. [21] | 2019 | 2008–2017 | 34 | 17/17 | Sweden | – |
Glebova et al. [22] | 2016 | 1970–2014 | 35/5591 | 6/29 | USA | 17 |
Ham et al. [23] | 2015 | 2000–2014 | 7/31 | 0/7 | Korea | – |
Jing et al. [24] | 201 | 2005–2010 | 24/0 | – | China | 12.67 |
Loveday et al. [25] | 2018 | 2009–2016 | 20/11 | 18/2 | Canada | 12.6 |
Miura et al. [26] | 2014 | 1998–2018 | 50/0 | 0/50 | Japan | 45.3 |
Miyazaki et al. [27] | 2017 | 1999–2015 | 21/0 | 9/12 | Japan | 11 |
Nakamura et al. [28] | 2016 | 1998–2015 | 80/0 | 2/78 | Japan | 53.5 |
Ocuin et al. [29] | 2016 | 2007–2015 | 30 | 27/1 | USA | 33 |
Okada et al. [30] | 2013 | 2005–2010 | 16/36 | 0/16 | Japan | 25 |
Perinel et al. [31] | 2016 | 2008–2014 | 14/97 | 4/10 | France | – |
Peters et al. [32] | 2016 | 2004–2016 | 17/51 | 15/2 | Netherlands | 8 |
Rehders et al. [33] | 2012 | 1998–2010 | 4/104 | – | Germany | – |
Sakuraba et al. [34] | 2012 | 1998–2010 | 7/0 | – | Japan | – |
Sato et al. [35] | 2016 | 2011–2014 | 17/0 | 2/15 | Japan | 14.4 |
Sugiura et al. [36] | 2017 | 2002–2014 | 16/71 | 0/16 | Japan | 36 |
Takahashi et al. [37] | 2011 | 1993–2010 | 16/27 | 0/16 | Japan | 15 |
Tanaka et al. [38] | 2012 | 1998–2007 | 42/0 | – | Japan | – |
Tee et al. [39] | 2018 | 1990–2017 | 111/0 | 65/46 | USA | 19 |
Ueda et al. [40] | 2019 | 2004–2015 | 31/0 | 24/7 | Japan | – |
Wang et al. [41] | 2014 | 2003–2012 | 15/0 | – | China | – |
Yamamoto et al. [42] | 2012 | 1991–2009 | 13/58 | – | Japan | 18 |
Yoshitomi et al. [43] | 2019 | 2010–2016 | 38/0 | 31/7 | Japan | 29.6/15.6 |
Zhou et al. [44] | 2014 | 2006–2013 | 12/0 | 9/3 | China | – |
Overall | 2011–2019 | 1970–2017 | 841/6270 | 364/363 | 9 | – |
Reference | Group | Age (median) | Sex (M/F) | Type of operation | Artery resected | Duration of surgery (min) | Blood loss (mL) |
---|---|---|---|---|---|---|---|
Addeo et al. [14] | AR | – | – | PD (13), TP (2), DP (9) | SMA (9), CA (12), CHA (1), SP (1), LHA (1) | – | – |
No AR | – | – | – | – | – | – | |
Amano et al. [15] | AR | 64.1 | 10/3 | PD (3), TP (4), DP (6) | CA (10), CHA (7) | 567 ± 132 (376–862) | 1311 ± 64 (860–2480) |
Bachellier et al. [16] | AR | 62 | 61/57 | PD (51), TP (18), DP (49) | CA (50), HA (29), SMA (35), others (4) | 600 (295–1145) | – |
Baumgartner et al. [17] | AR | 61 | 5/6 | DP (11) | CA (11) | 494 | 700 (500–4500) |
Beane et al. [18] | AR | 54 | 6/14 | DP (20) | CA (20) | 276 (164–617) | – |
No AR | 66 | 57/115 | DP (172) | – | 207 (66–581) | – | |
Cesaretti et al. [19] | AR | 56.4 | – | DP (5) | CA (5) | 550 (450–655) | 370 (300–600) |
Christians et al. [20] | AR | 62 | 4/6 | DP (6), CP (1), PD (2), TP (1) | CA (7), CHA (3) | 417 (298–574) | 800 (300–2500) |
Del Chiaro et al. [21] | AR | 65 | 19/15 | PD (9). TP (23), DP (2) | CA (32), SMA (3) | 426 ± 14 | 613 ± 72 |
Glebova et al. [22] | AR | 58 | 21/14 | PD (18), TP (1), PPPD (3), NS (3), DP (9), laparoscopic PD (1) | CA (15), CHA (21) | 319 ± 40 | 1285 ± 276 |
No AR | 63 | 2281/3310 | PD (1365), TP (90), PPPD (2530), NS (392), DP (1213), laparoscopic PD (1) | – | 355 ± 34 | 828 ± 220 | |
Ham et al. [23] | AR | 58 | 3/4 | DP (7) | CA (7) | 354 (307–520) | 727, p = 0.024 |
No AR | 67.5 | 16/15 | DP (31) | – | 286 (157–502) | 300, p = 0.024 | |
Jing et al. [24] | AR | 54.5 | 18/6 | DP | CA (24) | 200 ± 68 | 1779 ± 1934 |
Loveday et al. [25] | AR | 57 | 17/40 | PD (16), DP (2), TP (2) | SMA (10), CA and CHA (10) | 681 (448–960) | 1600 (500–2500) |
No AR | PD (11) | – | 563 (405–660) | 575 (350–1300) | |||
Miura et al. [26] | AR | 64 | 26/24 | DP (50) | CA (50) | 454 (306–1037) | 940 (420–15,970) |
Miyazaki et al. [27] | AR | 66 | 9/12 | PD (17), TP (4) | CHA (21) | 2290 (740–19,895) | 522 (390–774) |
Nakamura et al. [28] | AR | 65 | 40/40 | DP (80) | CA (80) | 436 (248–1037) | 880 (162–15,970) |
Ocuin et al. [29] | AR | 61.9 | 17/13 | DP (30) | CA (30) | 430.8 ± 229.9 | 1552.5 ± 1565.6 |
Okada et al. [30] | AR | 63 | 11/5 | DP (16) | CA (16) | 298 (212–465) | 1165 (410–2240) |
No AR | 68 | 23/13 | DP (36) | – | 203 (128–276) | 700 (10–2850) | |
Perinel et al. [31] | AR | 65 | 9/6 | PD (3), TP (9), DP (2) | SMA (6), CHA (4), CA (2), RRHA (2) | 380 ± 75 | 826 ± 415 |
Standard | 67 | 36/30 | PD (44), TP (10), DP (12) | – | 290 ± 75 | 428 ± 428 | |
VR | 67 | 20/11 | PD (20), TP (10), DP (1) | – | 330 ± 45 | 432 ± 356 | |
Peters et al. [32] | AR | 65 | 9/8 | DP (17) | CA (17) | 404 (342–480) | 900 (400–1000) |
No AR | 67 | 29/22 | DP (51) | – | 309 (220–370) | 525 (300–850) | |
Rehders et al. [33] | AR | – | – | – | SMA (4) | – | – |
Standard | – | – | – | – | – | – | |
VR | – | – | – | – | – | – | |
Sakuraba et al. [34] | AR | 61 | 0/7 | DP (1), PD (6) | CHA (7), CA (1) | – | – |
Sato et al. [35] | AR | 68 | 13/4 | DP (17) | CA (17) | 410 (248–564) | 420 (150–1650) |
Sugiura et al. [36] | AR | 70 | 10/6 | DP (16) | CA (16) | 338 (259–507) | 902 (461–1893) |
No AR | 71 | 44/32 | DP (71) | – | 263 (129–557) | 460 (76–2716) | |
Takahashi et al. [37] | AR | 65 | 8/8 | DP (16) | CA (16) | 237 ± 63 | 782 ± 82 |
No AR | 70 | 10/17 | DP (27) | – | 203 ± 83 | 634 ± 85 | |
Tanaka et al. [38] | AR | – | – | DP (42) | CA (42) | 478 (311–1037) | 1030 (420–15,970) |
Tee et al. [39] | AR | 62.9 | 62/49 | PD (45), DP (46), TP (20) | CA (49), HA (60), SMA (15), multivessel (15) | 472 ± 150 | 1265 ± 1442 |
Ueda et al. [40] | AR | 62 | 21/10 | DP (31) | CA (31) | 334 (175–584) | 1270 (305–10,270) |
Wang et al. [41] | AR | 59.2 | 8/7 | DP (15) | CA (15) | 295 (225–420) | 1000 (400–2000) |
Yamamoto et al. [42] | AR | 64 | 10/3 | DP (13) | CA (13) | 620 (370–840) | 1300 (570–4300) |
No AR | 66 | 39/19 | DP (58) | – | 360 (220–610) | 620 (27–2200) | |
Yoshitomie et al. [43] | AR (neoadjuvant/no neoadjuvant) | 66/62 | 26/12 | DP (38) | CA (38) | 350 ± 104/353 ± 87 | 1274 ± 961/1347 ± 1111 |
Zhou [44] | AR | 52 | 8/4 | DP (12) | CA (12) | 330 (280–440) | 1200 (800–2400) |
Reference | Group | Morbidity (%) | Pancreatic fistula (%) | DGE (%) | Postoperative bleeding (%) | Reoperation rate (%) | Mortality (%) | Hospital stay (days) | Median survival (months) | Actuarial survival (years, %) | R0 resection (%) | Histological arterial invasion (%) | Lymph node passivity (%) | |||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1 year | 2 years | 3 years | 5 years | |||||||||||||
Addeo et al. [14] | AR | 42 | – | – | – | – | – | – | 15 | 61 | – | 0 | – | – | 37.5 | – |
No AR | 24 | – | – | – | – | – | – | 22 | 81 | – | 24.1 | – | – | – | – | |
Amano et al. [15] | AR | 61 | 6 | 46 | – | – | 0 | 49 | – | 92 | – | – | – | 92 | 50 (CA), 0 (CHA) | 92 |
Bachellier et al. [16] | AR | 41.5 | 5.93 | – | – | 10.1 | 5.1 | 22 | 13.7 | 59 | – | 13 | 11.8 | 52.4 | 58 | 80.5 |
Baumgartner et al. [17] | AR | 45 | 36 | – | 8 | 0 | – | 9 | 26 | – | – | – | – | – | – | 91 |
Beane et al. [18] | AR | 35 | 10 | – | 35 | 10 | 10 | 8 | – | – | – | – | – | – | – | – |
No AR | 36 | 15 | 5 | – | 2 | 1 | 6 | – | – | – | – | – | – | – | – | |
Cesaretti et al. [19] | AR | 100 | 80 | 0 | – | 0 | 0 | – | 24 | – | – | 60 | – | 60 | – | 60 |
Christians et al. [20] | AR | 30 | 0 | 0 | 0 | 10 | 0 | 9 | – | – | – | – | – | – | 10 | – |
Del Chiaro et al. [21] | AR | 62 | 27.3 | – | – | 8.8 | 2.9 | 18 | – | 63.7 | – | 23.3 | 23.4 | 26 | 44 | 85 |
Glebova et al. [22] | AR | 89 | 9 | 11 | 6 | – | – | 13 | 22 | 50 | – | – | 19 | 57 | – | 91 |
No AR | 97 | 13 | 13 | 3 | – | – | 11 | 47 | 58 | – | – | 11 | 70 | – | 83 | |
Ham et al. [23] | AR | 100 | 100 | 14.3 | 0 | – | 0 | 23 | 15 | 100 | 44.4 | – | 71 | 100 | 57 | |
No AR | – | 68 | 0 | 3.2 | – | 3.2 | 14.5 | 25 | 73.7 | 55.3 | – | – | 80.6 | – | – | |
Jing et al. [24] | AR | 54 | 42 | 25 | – | – | 0 | – | 9.25 | 46 | – | 4 | – | – | – | – |
Loveday et al. [25] | AR | 65 | 0 | – | – | 25 | 5 | 11.5 | 14.8 | 65 | 10 | – | – | 100 | – | 60 |
No AR | 73 | 0 | – | – | 18 | 0 | 10 | 24.2 | 82 | 27 | – | – | 100 | – | 55 | |
Miura et al. [26] | AR | 54 | – | – | – | – | – | 39 | 24.7 | 80.7 | – | 32.3 | 24.3 | 92 | 28 | 72 |
Miyazaki et al. [27] | AR | 81 | 4.8 | 9.5 | – | – | 0 | – | 11 | 47.6 | – | 6.6 | 6.6 | 43 | 57 | 86 |
Nakamura et al. [28] | AR | – | 58.8 | 28.8 | – | 7.5 | 1.3 | 38 | 24.9 | 81.1 | – | 56.9 | 32.7 | 93 | – | 62.5 |
Ocuin et al. [29] | AR | 73 | 43 | – | – | 7 | 14 | 10.7 | 35 | – | – | – | – | 80 | 62 | 50 |
Okada et al. [30] | AR | – | 18.8 | 12.5 | 0 | 0 | 0 | – | 25 | 81 | 52 | – | – | 31 | – | – |
No AR | – | 27.8 | 0 | 2.8 | 0 | 0 | – | 32 | 81 | 53 | – | – | 81 | – | – | |
Perinel et al. [31] | AR | 14 | 0 | 14 | – | 0 | 0 | 23 | – | 92 | 55 | 17 | – | 57 | – | 71 |
Standard | 29 | 10 | 8 | – | 15 | 3 | 27 | – | 64 | 51 | 45 | – | 74 | – | 70 | |
VR | 32 | 3 | 6 | – | 6 | 3 | 23 | – | 76 | 52 | 33 | – | 39 | – | 90 | |
Peters et al. [32] | AR | 35 | 5.9 | 5.9 | 5.9 | – | 0 | 7 | 20 | 75 | – | – | – | 82 | – | 41.2 |
No AR | 24 | 21.6 | 7.8 | 2 | – | 0 | 6 | 19 | 85.2 | – | – | – | 92 | – | 40 | |
Rehders et al. [33] | AR | 0 | – | – | – | – | – | – | 17 | – | – | – | – | 75 | – | 50 |
Standard | 67 | – | – | – | – | – | – | 27.9 | – | – | – | – | 86 | – | 43 | |
VR | 49 | – | – | – | – | – | – | 23.4 | – | – | – | – | 83 | – | 20 | |
Sakuraba et al. [34] | AR | 43 | – | – | 15 | – | – | – | – | – | – | – | – | 86 | – | – |
Sato et al. [35] | AR | 41 | 41 | 12 | – | – | 0 | 34 | 16.9 | 74 | – | 45 | – | 94 | – | 76 |
Sugiura et al. [36] | AR | 88 | 44 | – | – | – | – | 26 | 17.5 | 75 | – | 21.4 | – | 62 | 56 | 88 |
No AR | 63 | 41 | – | – | – | – | 21 | 43.1 | 85.2 | – | 52.9 | – | 88 | – | 55 | |
Takahashi et al. [37] | AR | 56 | 31 | – | – | 12.5 | 6 | 38 | 9.7 | 42.6 | – | 25.6 | – | 56 | 75 | 56 |
No AR | 44 | 19 | – | – | 0 | 0 | 56 | 30.9 | 84.1 | – | 31.1 | – | 78 | 15 | 44 | |
Tanaka et al. [38] | AR | 43 | 17 | 12 | – | – | – | – | 24 | – | – | – | 25 | 93 | – | – |
Tee et al. [39] | AR | 54 | 23 | 23 | 17 | 16 | 13 | – | 28.5 | – | – | – | – | – | – | – |
Ueda et al. [40] | AR | 32.3 | 45.2 | – | – | – | 6.5 | 37 | 23.7 | 74.2 | – | 34.4 | – | 42 | 45 | 78 |
Wang et al. [41] | AR | 47 | 33 | – | – | – | – | 29.6 | 19 | 86.7 | – | 6.7 | 100 | – | – | |
Yamamoto et al. [42] | AR | 92 | 62 | 31 | 8 | – | 0 | 62 | 20.8 | – | 25.4 | – | – | 31 | 62 | – |
No AR | 60 | 45 | 55 | 3 | – | 0 | 25 | 21.1 | – | 45.9 | – | – | 74 | 48 | – | |
Yoshitomie et al. [43] | AR (neoadjuvant/no neoadjuvant) | 39 | 29 | 13 | – | – | 2.6 | 32/34 | 38.6/15.6 | 79 | 61 | 34 | – | 63 | – | 21 |
Zhou et al. [44] | AR | 75 | 25 | – | 0 | – | – | – | 10 | – | – | – | – | – | – | – |
Reference | A | B | C | D | E | F | G | H |
---|---|---|---|---|---|---|---|---|
Beane et al. [18] | – | – | – | ? | – | – | – | – |
Ham et al. [23] | – | – | – | ? | ? | – | – | – |
Loveday et al. [25] | – | – | + | + | + | + | + | + |
Okada et al. [30] | – | – | – | ? | + | – | ? | – |
Perinel et al. [31] | – | – | + | – | – | – | – | – |
Peters et al. [32] | – | – | – | ? | – | – | – | – |
Sugiura et al. [36] | – | – | – | ? | + | – | ? | – |
Statistical analysis
Results
Systematic review and combined data analysis
Meta-analysis
Reference | Inclusion period | Sample (AR/no AR) | AR neoadjuvant therapy (+/−) | Operation (AR/no AR) | Artery resected | Reconstruction (Y/N) | Planned resection (Y/U) | Median survival (months) (AR/no AR) | Study type | Risk of bias |
---|---|---|---|---|---|---|---|---|---|---|
Beane et al. [18] | 2011–2012 | 20/172 | 5/15 − | DP (20)/DP (172) | CA (20) | N | U | – | Prospective | High |
Ham et al. [23] | 2000–2014 | 7/31 | 0/7 − | DP (7)/DP (31) | CA (7) | N | U | 15/25 | Retrospective | High |
Loveday et al. [25] | 2009–2016 | 20/11 | 18/2 + | DP (2), PD (16), TP (2)/PD (11) | SMA (10), CA and CHA (10) | Y | Y | 14.8/24.2 | Retrospective | Low |
Okada et al. [30] | 2005–2010 | 16/36 | 0/16 − | DP (16)/DP (36) | CA (16) | N | Y | 25/32 | Prospective | High |
Perinel et al. [31] | 2008–2014 | 14/97 | 4/10 − | DP (2), PD (3), TP (9)/PD (64), TP (20), DP (13) | CA (2), SMA (6), CHA (4), RRHA (2) | Y | Y | – | Prospective | High |
Peters et al. [32] | 2004–2016 | 17/51 | 15/2 + | DP (17)/DP (51) | CA (17) | U | U | 19/20 | Prospective | High |
Sugiura et al. [36] | 2002–2014 | 16/71 | 0/16 − | DP (16)/DP (71) | CA (16) | N | Y | 17.5/43.1 | Retrospective | High |
Overall | 2000–2016 | 110/469 | 42/68 | DP (80), PD (19), TP (11)/DP (374), PD (75), TP (20) | CA or HAB (100), SMA (10) | Y (34) | Y (66) | 18.6/32 (WMS) | Retrospective (3), prospective (4) | High (6), low (1) |