Different Periampullary Types and Subtypes Leading to Different Perioperative Outcomes of Pancreatoduodenectomy : Reality and Not a Myth; An International Multicenter Cohort Study
Uijterwijk, Bas A. (Cancer Center Amsterdam)
Lemmers, Daniël H.L. (Cancer Center Amsterdam)
Fusai, Giuseppe Kito (Royal Free London NHS Foundation Trust)
Groot Koerkamp, Bas (Erasmus Medical Center)
Koek, Sharnice (Department of Surgery. Fiona Stanley Hospital)
Zerbi, Alessandro (Department of Pancreatic Surgery. IRCCS Humanitas Research Hospital)
Sparrelid, Ernesto (Karolinska University Hospital and Karolinska Institutet (Suècia))
Boggi, Ugo (Department of Surgery. Pisa University Hospital)
Luyer, M. (Catharina Hospital Eindhoven (Eindhoven, Països Baixos))
Ielpo, Benedetto (Hospital del Mar (Barcelona, Catalunya))
Salvia, Roberto (University Hospital of Verona. Department of Surgery)
Goh, Brian K.P. (Surgery Academic Clinical Programme. Duke-National University of Singapore Medical School)
Kazemier, Geert (Amsterdam Universitair Medische Centra (Amsterdam, Països Baixos))
Björnsson, Bergthor (Department of Surgery in Linköping. Department of Biomedical and Clinical Sciences. Linköping University)
Serradilla-Martín, Mario (Hospital Universitario Miguel Servet (Saragossa))
Mazzola, Michele (ASST Grande Ospedale Metropolitano Niguarda)
Mavroeidis, Vasileios K. (Department of Hepatobiliary and Pancreatic Surgery. Oxford University Hospitals. NHS Foundation Trust)
Sánchez-Cabús, Santiago (Institut de Recerca Sant Pau)
Pessaux, Patrick (Hepatobiliary and Pancreatic Surgical Unit. Nouvel Hôpital Civil (NHC))
White, Steven (Department of Surgery. Newcastle Upon Tyne Hospitals. NHS Foundation Trust)
Alseidi, Adnan (Virginia Mason Medical Center (Seattle, Estats Units d'Amèrica))
Valle, Raffaele Dalla (Department of Surgery. University Hospital of Parma)
Korkolis, Dimitris (Department of Surgery. Hellenic Anticancer Hospital 'Saint Savvas')
Bolm, Louisa R. (Department of Surgery. University Medical Center Schleswig-Holstein)
Soonawalla, Zahir (Oxford University Hospitals. NHS Foundation Trus)
Roberts, Keith J. (University of Birmingham)
Vladimirov, Miljana (Hospital Nuremberg. PMU Nürnberg)
Mazzotta, Alessandro (Institut Mutualiste Montsouris)
Kleeff, Jorg (Martin-Luther University Halle-Wittenberg)
Suarez Muñoz, Miguel Angel (University Hospital Virgen de la Victoria)
Besselink, Marc G. (Universiteit van Amsterdam)
Hilal, Mohammed Abu (Istituto Ospedaliero Fondazione Poliambulanza (Brescia, Itàlia))
Universitat Autònoma de Barcelona

Date:	2024
Abstract:	This international multicenter cohort study included 30 centers. Patients with duodenal adenocarcinoma (DAC), intestinal-type (AmpIT) and pancreatobiliary-type (AmpPB) ampullary adenocarcinoma, distal cholangiocarcinoma (dCCA), and pancreatic ductal adenocarcinoma (PDAC) were included. The primary outcome was 30-day or in-hospital mortality, and secondary outcomes were major morbidity (Clavien-Dindo 3b≥), clinically relevant post-operative pancreatic fistula (CR-POPF), and length of hospital stay (LOS). Results: Overall, 3622 patients were included in the study (370 DAC, 811 AmpIT, 895 AmpPB, 1083 dCCA, and 463 PDAC). Mortality rates were comparable between DAC, AmpIT, AmpPB, and dCCA (ranging from 3. 7% to 5. 9%), while lower for PDAC (1. 5%, p = 0. 013). Major morbidity rate was the lowest in PDAC (4. 4%) and the highest for DAC (19. 9%, p < 0. 001). The highest rates of CR-POPF were observed in DAC (27. 3%), AmpIT (25. 5%), and dCCA (27. 6%), which were significantly higher compared to AmpPB (18. 5%, p = 0. 001) and PDAC (8. 3%, p < 0. 001). The shortest LOS was found in PDAC (11 d vs. 14-15 d, p < 0. 001). Discussion: In conclusion, this study shows significant variations in perioperative mortality, post-operative complications, and hospital stay among different periampullary cancers, and between the ampullary subtypes. Further research should assess the biological characteristics and tissue reactions associated with each type of periampullary cancer, including subtypes, in order to improve patient management and personalized treatment.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Complications ; Non-pancreatic periampullary cancer ; Pancreatoduodenectomy ; Tumor behavior
Published in:	Cancers, Vol. 16 Núm. 5 (march 2024) , p. 899, ISSN 2072-6694

DOI: 10.3390/cancers16050899
PMID: 38473260

11 p, 650.8 KB

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