Hepatopancreatoduodenectomy -a controversial treatment for bile duct and gallbladder cancer from a European perspective

Melroy A D'Souza; Valentinus T Valdimarsson; Tommaso Campagnaro; Francois Cauchy; Nikolaos A Chatzizacharias; Mathieu D'Hondt; Bobby Dasari; Alessandro Ferrero; Lotte C Franken; Giuseppe Fusai; Alfredo Guglielmi; Jeroen Hagendoorn; Camila Hidalgo Salinas; Frederik J H Hoogwater; Rosa Jorba; Nariman Karanjia; Wolfram T Knoefel; Philipp Kron; Rajiv Lahiri; Serena Langella; Bertrand Le Roy; Nadja Lehwald-Tywuschik; Mickael Lesurtel; Jun Li; J Peter A Lodge; Erini Martinou; Izaak Q Molenaar; Andrej Nikov; Ignasi Poves; Fadi Rassam; Nadia Russolillo; Olivier Soubrane; Stefan Stättner; Ronald M van Dam; Thomas M van Gulik; Alejandro Serrablo; Tom M Gallagher; Christian Sturesson; E-AHPBA scientific and research committee

doi:10.1016/j.hpb.2019.12.008

Hepatopancreatoduodenectomy -a controversial treatment for bile duct and gallbladder cancer from a European perspective

Melroy A D'Souza, Valentinus T Valdimarsson, Tommaso Campagnaro, Francois Cauchy, Nikolaos A Chatzizacharias, Mathieu D'Hondt, Bobby Dasari, Alessandro Ferrero, Lotte C Franken, Giuseppe Fusai, Alfredo Guglielmi, Jeroen Hagendoorn, Camila Hidalgo Salinas, Frederik J H Hoogwater, Rosa Jorba, Nariman Karanjia, Wolfram T Knoefel, Philipp Kron, Rajiv Lahiri, Serena LangellaBertrand Le Roy, Nadja Lehwald-Tywuschik, Mickael Lesurtel, Jun Li, J Peter A Lodge, Erini Martinou, Izaak Q Molenaar, Andrej Nikov, Ignasi Poves, Fadi Rassam, Nadia Russolillo, Olivier Soubrane, Stefan Stättner, Ronald M van Dam, Thomas M van Gulik, Alejandro Serrablo, Tom M Gallagher, Christian Sturesson^*, E-AHPBA scientific and research committee

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

14 Citations (Web of Science)

Abstract

BACKGROUND: Hepatopancreatoduodenectomy (HPD) is an aggressive operation for treatment of advanced bile duct and gallbladder cancer associated with high perioperative morbidity and mortality, and uncertain oncological benefit in terms of survival. Few reports on HPD from Western centers exist. The purpose of this study was to evaluate safety and efficacy for HPD in European centers.

METHOD: Members of the European-African HepatoPancreatoBiliary Association were invited to report all consecutive patients operated with HPD for bile duct or gallbladder cancer between January 2003 and January 2018. The patient and tumor characteristics, perioperative and survival outcomes were analyzed.

RESULTS: In total, 66 patients from 19 European centers were included in the analysis. 90-day mortality rate was 17% and 13% for bile duct and gallbladder cancer respectively. All factors predictive of perioperative mortality were patient and disease-specific. The three-year overall survival excluding 90-day mortality was 80% for bile duct and 30% for gallbladder cancer (P = 0.013). In multivariable analysis R0-resection had a significant impact on overall survival.

CONCLUSION: HPD, although being associated with substantial perioperative mortality, can offer a survival benefit in patient subgroups with bile duct cancer and gallbladder cancer. To achieve negative resection margins is paramount for an improved survival outcome.

Original language	English
Pages (from-to)	1339-1348
Number of pages	10
Journal	HPB
Volume	22
Issue number	9
Early online date	30 Dec 2019
DOIs	https://doi.org/10.1016/j.hpb.2019.12.008
Publication status	Published - Sep 2020

Keywords

INTERNATIONAL STUDY-GROUP
MAJOR HEPATECTOMY
PERIHILAR CHOLANGIOCARCINOMA
RISK SCORE
PANCREATIC FISTULA
BILIARY
RESECTION
LIVER
PANCREATICODUODENECTOMY
DEFINITION

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10.1016/j.hpb.2019.12.008

Cite this

D'Souza, M. A., Valdimarsson, V. T., Campagnaro, T., Cauchy, F., Chatzizacharias, N. A., D'Hondt, M., Dasari, B., Ferrero, A., Franken, L. C., Fusai, G., Guglielmi, A., Hagendoorn, J., Hidalgo Salinas, C., Hoogwater, F. J. H., Jorba, R., Karanjia, N., Knoefel, W. T., Kron, P., Lahiri, R., ... E-AHPBA scientific and research committee (2020). Hepatopancreatoduodenectomy -a controversial treatment for bile duct and gallbladder cancer from a European perspective. HPB, 22(9), 1339-1348. https://doi.org/10.1016/j.hpb.2019.12.008

@article{9e6d5ef528684bc48c5d7db0f47cded1,

title = "Hepatopancreatoduodenectomy -a controversial treatment for bile duct and gallbladder cancer from a European perspective",

abstract = "BACKGROUND: Hepatopancreatoduodenectomy (HPD) is an aggressive operation for treatment of advanced bile duct and gallbladder cancer associated with high perioperative morbidity and mortality, and uncertain oncological benefit in terms of survival. Few reports on HPD from Western centers exist. The purpose of this study was to evaluate safety and efficacy for HPD in European centers.METHOD: Members of the European-African HepatoPancreatoBiliary Association were invited to report all consecutive patients operated with HPD for bile duct or gallbladder cancer between January 2003 and January 2018. The patient and tumor characteristics, perioperative and survival outcomes were analyzed.RESULTS: In total, 66 patients from 19 European centers were included in the analysis. 90-day mortality rate was 17% and 13% for bile duct and gallbladder cancer respectively. All factors predictive of perioperative mortality were patient and disease-specific. The three-year overall survival excluding 90-day mortality was 80% for bile duct and 30% for gallbladder cancer (P = 0.013). In multivariable analysis R0-resection had a significant impact on overall survival.CONCLUSION: HPD, although being associated with substantial perioperative mortality, can offer a survival benefit in patient subgroups with bile duct cancer and gallbladder cancer. To achieve negative resection margins is paramount for an improved survival outcome.",

keywords = "INTERNATIONAL STUDY-GROUP, MAJOR HEPATECTOMY, PERIHILAR CHOLANGIOCARCINOMA, RISK SCORE, PANCREATIC FISTULA, BILIARY, RESECTION, LIVER, PANCREATICODUODENECTOMY, DEFINITION",

author = "D'Souza, {Melroy A} and Valdimarsson, {Valentinus T} and Tommaso Campagnaro and Francois Cauchy and Chatzizacharias, {Nikolaos A} and Mathieu D'Hondt and Bobby Dasari and Alessandro Ferrero and Franken, {Lotte C} and Giuseppe Fusai and Alfredo Guglielmi and Jeroen Hagendoorn and {Hidalgo Salinas}, Camila and Hoogwater, {Frederik J H} and Rosa Jorba and Nariman Karanjia and Knoefel, {Wolfram T} and Philipp Kron and Rajiv Lahiri and Serena Langella and {Le Roy}, Bertrand and Nadja Lehwald-Tywuschik and Mickael Lesurtel and Jun Li and Lodge, {J Peter A} and Erini Martinou and Molenaar, {Izaak Q} and Andrej Nikov and Ignasi Poves and Fadi Rassam and Nadia Russolillo and Olivier Soubrane and Stefan St{\"a}ttner and {van Dam}, {Ronald M} and {van Gulik}, {Thomas M} and Alejandro Serrablo and Gallagher, {Tom M} and Christian Sturesson and {E-AHPBA scientific and research committee}",

year = "2020",

month = sep,

doi = "10.1016/j.hpb.2019.12.008",

language = "English",

volume = "22",

pages = "1339--1348",

journal = "HPB",

issn = "1365-182X",

publisher = "ELSEVIER SCI LTD",

number = "9",

}

D'Souza, MA, Valdimarsson, VT, Campagnaro, T, Cauchy, F, Chatzizacharias, NA, D'Hondt, M, Dasari, B, Ferrero, A, Franken, LC, Fusai, G, Guglielmi, A, Hagendoorn, J, Hidalgo Salinas, C, Hoogwater, FJH, Jorba, R, Karanjia, N, Knoefel, WT, Kron, P, Lahiri, R, Langella, S, Le Roy, B, Lehwald-Tywuschik, N, Lesurtel, M, Li, J, Lodge, JPA, Martinou, E, Molenaar, IQ, Nikov, A, Poves, I, Rassam, F, Russolillo, N, Soubrane, O, Stättner, S, van Dam, RM, van Gulik, TM, Serrablo, A, Gallagher, TM, Sturesson, C & E-AHPBA scientific and research committee 2020, 'Hepatopancreatoduodenectomy -a controversial treatment for bile duct and gallbladder cancer from a European perspective', HPB, vol. 22, no. 9, pp. 1339-1348. https://doi.org/10.1016/j.hpb.2019.12.008

TY - JOUR

T1 - Hepatopancreatoduodenectomy -a controversial treatment for bile duct and gallbladder cancer from a European perspective

AU - D'Souza, Melroy A

AU - Valdimarsson, Valentinus T

AU - Campagnaro, Tommaso

AU - Cauchy, Francois

AU - Chatzizacharias, Nikolaos A

AU - D'Hondt, Mathieu

AU - Dasari, Bobby

AU - Ferrero, Alessandro

AU - Franken, Lotte C

AU - Fusai, Giuseppe

AU - Guglielmi, Alfredo

AU - Hagendoorn, Jeroen

AU - Hidalgo Salinas, Camila

AU - Hoogwater, Frederik J H

AU - Jorba, Rosa

AU - Karanjia, Nariman

AU - Knoefel, Wolfram T

AU - Kron, Philipp

AU - Lahiri, Rajiv

AU - Langella, Serena

AU - Le Roy, Bertrand

AU - Lehwald-Tywuschik, Nadja

AU - Lesurtel, Mickael

AU - Li, Jun

AU - Lodge, J Peter A

AU - Martinou, Erini

AU - Molenaar, Izaak Q

AU - Nikov, Andrej

AU - Poves, Ignasi

AU - Rassam, Fadi

AU - Russolillo, Nadia

AU - Soubrane, Olivier

AU - Stättner, Stefan

AU - van Dam, Ronald M

AU - van Gulik, Thomas M

AU - Serrablo, Alejandro

AU - Gallagher, Tom M

AU - Sturesson, Christian

AU - E-AHPBA scientific and research committee

PY - 2020/9

Y1 - 2020/9

N2 - BACKGROUND: Hepatopancreatoduodenectomy (HPD) is an aggressive operation for treatment of advanced bile duct and gallbladder cancer associated with high perioperative morbidity and mortality, and uncertain oncological benefit in terms of survival. Few reports on HPD from Western centers exist. The purpose of this study was to evaluate safety and efficacy for HPD in European centers.METHOD: Members of the European-African HepatoPancreatoBiliary Association were invited to report all consecutive patients operated with HPD for bile duct or gallbladder cancer between January 2003 and January 2018. The patient and tumor characteristics, perioperative and survival outcomes were analyzed.RESULTS: In total, 66 patients from 19 European centers were included in the analysis. 90-day mortality rate was 17% and 13% for bile duct and gallbladder cancer respectively. All factors predictive of perioperative mortality were patient and disease-specific. The three-year overall survival excluding 90-day mortality was 80% for bile duct and 30% for gallbladder cancer (P = 0.013). In multivariable analysis R0-resection had a significant impact on overall survival.CONCLUSION: HPD, although being associated with substantial perioperative mortality, can offer a survival benefit in patient subgroups with bile duct cancer and gallbladder cancer. To achieve negative resection margins is paramount for an improved survival outcome.

AB - BACKGROUND: Hepatopancreatoduodenectomy (HPD) is an aggressive operation for treatment of advanced bile duct and gallbladder cancer associated with high perioperative morbidity and mortality, and uncertain oncological benefit in terms of survival. Few reports on HPD from Western centers exist. The purpose of this study was to evaluate safety and efficacy for HPD in European centers.METHOD: Members of the European-African HepatoPancreatoBiliary Association were invited to report all consecutive patients operated with HPD for bile duct or gallbladder cancer between January 2003 and January 2018. The patient and tumor characteristics, perioperative and survival outcomes were analyzed.RESULTS: In total, 66 patients from 19 European centers were included in the analysis. 90-day mortality rate was 17% and 13% for bile duct and gallbladder cancer respectively. All factors predictive of perioperative mortality were patient and disease-specific. The three-year overall survival excluding 90-day mortality was 80% for bile duct and 30% for gallbladder cancer (P = 0.013). In multivariable analysis R0-resection had a significant impact on overall survival.CONCLUSION: HPD, although being associated with substantial perioperative mortality, can offer a survival benefit in patient subgroups with bile duct cancer and gallbladder cancer. To achieve negative resection margins is paramount for an improved survival outcome.

KW - INTERNATIONAL STUDY-GROUP

KW - MAJOR HEPATECTOMY

KW - PERIHILAR CHOLANGIOCARCINOMA

KW - RISK SCORE

KW - PANCREATIC FISTULA

KW - BILIARY

KW - RESECTION

KW - LIVER

KW - PANCREATICODUODENECTOMY

KW - DEFINITION

U2 - 10.1016/j.hpb.2019.12.008

DO - 10.1016/j.hpb.2019.12.008

M3 - Article

C2 - 31899044

VL - 22

SP - 1339

EP - 1348

JO - HPB

JF - HPB

SN - 1365-182X

IS - 9

ER -