Differences in Lymph Node Metastases Patterns Among Non-pancreatic Periampullary Cancers and Histologic Subtypes : An International Multicenter Retrospective Cohort Study and Systematic Review
Uijterwijk, Bas A. (Cancer Center Amsterdam)
Lemmers, Daniël H. (Cancer Center Amsterdam)
Fusai, Giuseppe Kito (Royal Free London NHS Foundation Trust)
Zerbi, Alessandro (Humanitas Research Hospital (Itàlia))
Salvia, Roberto (University of Verona Hospital Trust)
Sparrelid, Ernesto (Karolinska University Hospital)
White, Steven (Newcastle Upon Tyne Hospitals NHS Trust (Newcastle, Regne Unit))
Björnsson, Bergthor (Linköping University)
Mavroeidis, Vasileios K. (Oxford University Hospitals NHS Foundation Trust)
Roberts, Keith J. (University of Birmingham)
Mazzola, Michele (ASST Grande Ospedale Metropolitano Niguarda)
Sánchez-Cabús, Santiago (Institut de Recerca Sant Pau)
Soonawalla, Zahir (Oxford University Hospitals NHS Foundation Trust)
Korkolis, Dimitris (Hellenic Anticancer Hospital "Saint Savvas")
Serradilla, Mario (Hospital Universitario Miguel Servet (Saragossa))
Pessaux, Patrick (Nouvel Hôpital Civil (NHC))
Luyer, Misha (Catharina Hospital Eindhoven (Eindhoven, Països Baixos))
Mowbray, Nicholas (Morriston Hospital)
Ielpo, Benedetto (Hospital del Mar (Barcelona, Catalunya))
Mazzotta, Alessandro (Institut Mutualiste Montsouris)
Kleeff, Jorg (Martin-Luther University Halle-Wittenberg)
Boggi, Ugo (Pisa University Hospital)
Suarez Muñoz, Miguel Angel (Hospital Universitario Virgen de la Victoria (Màlaga, Andalusia))
Goh, Brian K.P. (Duke-National University of Singapore)
Andreotti, Elena (Fondazione Poliambulanza-Istituto Ospedaliero)
Wilmink, Hanneke (University of Amsterdam)
Ghidini, Michele (Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico (Milà, Itàlia))
Zaniboni, Alberto (Fondazione Poliambulanza-Istituto Ospedaliero)
Verbeke, Caroline (Oslo University Hospital (Oslo, Noruega))
Adsay, Volkan (Koç University Hospital)
Bianchi, Denise (Fondazione Poliambulanza-Istituto Ospedaliero)
Besselink, M.G. (Location University of Amsterdam)
Abu Hilal, Mohammad (Fondazione Poliambulanza-Istituto Ospedaliero)
Nappo, Gennaro
Ghorbani, Poya
Malleo, Giuseppe (Fondazione Poliambulanza-Istituto Ospedaliero)
Lancelotti, Francesco
Napoli, Niccolò
Robinson, Stuart
Khalil, Khalid
Ramirez-Del Val, Alejandro
Mortimer, Matthew C.M.
Al-Sarireh, Bilal
Koh, Ye Xin
Bhogal, Ricky
Serrablo, Alejandro
Gayet, Brice
Johansen, Karin
Ramaekers, Mark
Giani, Alessandro
Universitat Autònoma de Barcelona

Fecha:	2024
Resumen:	Standard lymphadenectomy for pancreatoduodenectomy is defined for pancreatic ductal adenocarcinoma and adopted for patients with non-pancreatic periampullary cancer (NPPC), ampullary adenocarcinoma (AAC), distal cholangiocarcinoma (dCCA), or duodenal adenocarcinoma (DAC). This study aimed to compare the patterns of lymph node metastases among the different NPPCs in a large series and in a systematic review to guide the discussion on surgical lymphadenectomy and pathology assessment. This retrospective cohort study included patients after pancreatoduodenectomy for NPPC with at least one lymph node metastasis (2010-2021) from 24 centers in nine countries. The primary outcome was identification of lymph node stations affected in case of a lymph node metastasis per NPPC. A separate systematic review included studies on lymph node metastases patterns of AAC, dCCA, and DAC. The study included 2367 patients, of whom 1535 had AAC, 616 had dCCA, and 216 had DAC. More patients with pancreatobiliary type AAC had one or more lymph node metastasis (67. 2% vs 44. 8%; P < 0. 001) compared with intestinal-type, but no differences in metastasis pattern were observed. Stations 13 and 17 were most frequently involved (95%, 94%, and 90%). Whereas dCCA metastasized more frequently to station 12 (13. 0% vs 6. 4% and 7. 0%, P = 0. 005), DAC metastasized more frequently to stations 6 (5. 0% vs 0% and 2. 7%; P < 0. 001) and 14 (17. 0% vs 8. 4% and 11. 7%, P = 0. 015). This study is the first to comprehensively demonstrate the differences and similarities in lymph node metastases spread among NPPCs, to identify the existing research gaps, and to underscore the importance of standardized lymphadenectomy and pathologic assessment for AAC, dCCA, and DAC.
Derechos:	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.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	Adenocarcinoma ; Aged ; Ampulla of Vater ; Bile Duct Neoplasms ; Carcinoma, Pancreatic Ductal ; Cholangiocarcinoma ; Common Bile Duct Neoplasms ; Duodenal Neoplasms ; Female ; Follow-Up Studies ; Humans ; Lymph Node Excision ; Lymph Nodes ; Lymphatic Metastasis ; Male ; Middle Aged ; Pancreatic Neoplasms ; Pancreaticoduodenectomy ; Prognosis ; Retrospective Studies
Publicado en:	Annals of Surgical Oncology, Vol. 31 Núm. 7 (july 2024) , p. 4654-4664, ISSN 1534-4681

DOI: 10.1245/s10434-024-15213-z
PMID: 38602578

11 p, 747.4 KB

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