TY - JOUR
T1 - Outcome of minimally invasive and open pancreatoduodenectomy in patients with intestinal- and pancreatobiliary subtype ampullary cancer
T2 - an international multicenter cohort study
AU - Uijterwijk, Bas A.
AU - Moekotte, Alma
AU - Boggi, Ugo
AU - Mazzola, Michele
AU - Koerkamp, Bas Groot
AU - Valle, Raffaele Dalla
AU - Mazzotta, Alessandro
AU - Luyer, Misha
AU - Kazemier, Geert
AU - Ielpo, Benedetto
AU - Muñoz, Miguel Angel Suarez
AU - Bolm, Louisa
AU - Björnsson, Bergthor
AU - Pessaux, Patrick
AU - Kleeff, Jorg
AU - Fusai, Giuseppe Kito
AU - Sparrelid, Ernesto
AU - Zerbi, Alessandro
AU - Lemmers, Daniël H.
AU - Alseidi, Adnan
AU - Vladimirov, Miljana
AU - Roberts, Keith J.
AU - Salvia, Roberto
AU - Soonawalla, Zahir
AU - Korkolis, Dimitris
AU - Serradilla-Martín, Mario
AU - Mavroeidis, Vasileios K.
AU - Bouwense, Stefan A.W.
AU - Besselink, Marc G.
AU - Hilal, Mohammed Abu
AU - International Study Group on non-pancreatic periampullary Cancer
N1 - Funding Information:
Conflicts of interests : Mario Serradilla-Mart\u00EDn received research funding from Baxter S.L.. Patrick Pessaux is co-founder of Virtualisurg; Geert Kazemier is Chairman of the Advisory Board of Renovaro Inc.; Marc G. Besselink has received grants from Intuitive for the LEARNBOT European robot Whipple training program, the DIPLOMA-2 trial, and the E-MIPS quality registry, from Medtronic for the investigator-initiated DIPLOMA trial and from Ethicon for the PANDORA trial and the E-MIPS quality registry; Mohammed Abu Hilal received funding from Associazione Italiana per la Ricerca sul Cancro (AIRC); All remaining authors claim no conflicts of interests and no disclosures.
Publisher Copyright:
© 2024 Wolters Kluwer Health. All rights reserved.
PY - 2024/1/1
Y1 - 2024/1/1
N2 - Objective To compare minimally invasive and open pancreatoduodenectomy in different subtypes of ampullary adenocarcinoma. Summary Background Data Ampullary adenocarcinoma (AAC) is widely seen as the best indication for minimally invasive pancreatoduodenectomy (MIPD) due to the lack of vascular involvement and dilated bile and pancreatic duct. However, it is unknown whether outcomes of MIPD for AAC differ between the pancreatobiliary (AAC-PB) and intestinal (AAC-IT) subtypes as large studies are lacking. Methods This is an international cohort study, encompassing 27 centers from 12 countries. Outcome of MIPD and open pancreatoduodenectomy (OPD) were compared in patients with AAC-IT and AAC-PB. Primary end points were R1 rate, lymph node yield, and 5-year overall survival (5yOS). Results Overall, 1187 patients after MIPD for AAC were included, of whom 572 with AAC-IT (62 MIPD, 510 OPD) and 615 with AAC-PB (41 MIPD and 574 OPD). The rate of R1 resection was not significantly different between MIPD and OPD for both AAC-IT (3.4% vs 6.9%, P=0,425) and AAC-PB (9.8% vs 14.9%, P=0,625). AAC-IT, more lymph nodes were resected with MIPD group (19 vs 16, P=0.007), compared to OPD. The 5y-OS did not differ after MIPD and OPD for both AAC-IT (56.8% vs 59.5%, P=0.827 and AAC-PB (52.5% vs 44.4%, P=0.357). The rates of surgical complication between MIPD and OPD did not differ between AmpIT and AmpPB. Discussion This international multicenter study found no differences in outcomes between MIPD and OPD for AAC-IT and AAC-PB. MIPD and OPD demonstrated comparable outcomes in oncological resection, survival and surgical outcomes for both subtypes of AAC. BACKGROUND Ampullary adenocarcinoma (AAC) is a relatively rare malignancy in the periampullary region treated with pancreatoduodenectomy.
1,2 Histologically, AAC can be classified into pancreatobiliary (AAC-PB), intestinal (AAC-IT), and mixed subtypes, each exhibiting distinct biological characteristics, tumor behavior, and long-term survival outcomes.
AB - Objective To compare minimally invasive and open pancreatoduodenectomy in different subtypes of ampullary adenocarcinoma. Summary Background Data Ampullary adenocarcinoma (AAC) is widely seen as the best indication for minimally invasive pancreatoduodenectomy (MIPD) due to the lack of vascular involvement and dilated bile and pancreatic duct. However, it is unknown whether outcomes of MIPD for AAC differ between the pancreatobiliary (AAC-PB) and intestinal (AAC-IT) subtypes as large studies are lacking. Methods This is an international cohort study, encompassing 27 centers from 12 countries. Outcome of MIPD and open pancreatoduodenectomy (OPD) were compared in patients with AAC-IT and AAC-PB. Primary end points were R1 rate, lymph node yield, and 5-year overall survival (5yOS). Results Overall, 1187 patients after MIPD for AAC were included, of whom 572 with AAC-IT (62 MIPD, 510 OPD) and 615 with AAC-PB (41 MIPD and 574 OPD). The rate of R1 resection was not significantly different between MIPD and OPD for both AAC-IT (3.4% vs 6.9%, P=0,425) and AAC-PB (9.8% vs 14.9%, P=0,625). AAC-IT, more lymph nodes were resected with MIPD group (19 vs 16, P=0.007), compared to OPD. The 5y-OS did not differ after MIPD and OPD for both AAC-IT (56.8% vs 59.5%, P=0.827 and AAC-PB (52.5% vs 44.4%, P=0.357). The rates of surgical complication between MIPD and OPD did not differ between AmpIT and AmpPB. Discussion This international multicenter study found no differences in outcomes between MIPD and OPD for AAC-IT and AAC-PB. MIPD and OPD demonstrated comparable outcomes in oncological resection, survival and surgical outcomes for both subtypes of AAC. BACKGROUND Ampullary adenocarcinoma (AAC) is a relatively rare malignancy in the periampullary region treated with pancreatoduodenectomy.
1,2 Histologically, AAC can be classified into pancreatobiliary (AAC-PB), intestinal (AAC-IT), and mixed subtypes, each exhibiting distinct biological characteristics, tumor behavior, and long-term survival outcomes.
KW - ampullary adenocarcinoma
KW - intestinal-type
KW - Minimally invasive pancreatoduodenectomy
KW - pancreatobiliary-type
KW - retrospective cohort study
KW - survival
U2 - 10.1097/SLA.0000000000006515
DO - 10.1097/SLA.0000000000006515
M3 - Article
SN - 0003-4932
JO - Annals of Surgery
JF - Annals of Surgery
M1 - 10.1097/SLA.0000000000006515
ER -