Different Periampullary Types and Subtypes Leading to Different Perioperative Outcomes of Pancreatoduodenectomy

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 o...

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Autores: Uijterwijk, Bas A.|||0000-0003-2479-2092, Lemmers, Daniël H.L.|||0000-0002-3534-1089, Fusai, Giuseppe Kito, Groot Koerkamp, Bas|||0000-0003-1917-6973, Koek, Sharnice, Zerbi, Alessandro|||0000-0002-9176-0448, Sparrelid, Ernesto, Boggi, Ugo, Luyer, M.|||0000-0002-9483-1520, Ielpo, Benedetto|||0000-0003-3129-3208, Salvia, Roberto|||0000-0002-3514-8473, Goh, Brian K.P., Kazemier, Geert, Björnsson, Bergthor|||0000-0001-9704-1260, Serradilla-Martín, Mario|||0000-0002-2466-0711, Mazzola, Michele|||0000-0002-3546-197X, Mavroeidis, Vasileios K., Sánchez-Cabús, Santiago|||0000-0002-0575-1466, Pessaux, Patrick, White, Steven, Alseidi, Adnan|||0000-0002-0365-1955, Valle, Raffaele Dalla, Korkolis, Dimitris|||0000-0003-0682-2374, Bolm, Louisa R.|||0000-0002-1612-1857, Soonawalla, Zahir, Roberts, Keith J., Vladimirov, Miljana, Mazzotta, Alessandro|||0000-0001-7363-2592, Kleeff, Jorg|||0000-0003-3432-6669, Suarez Muñoz, Miguel Angel|||0000-0001-9012-8670, Besselink, Marc G., Hilal, Mohammed Abu|||0000-0002-3162-4639
Tipo de recurso: artículo
Fecha de publicación:2024
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:305604
Acceso en línea:https://ddd.uab.cat/record/305604
https://dx.doi.org/urn:doi:10.3390/cancers16050899
Access Level:acceso abierto
Palabra clave:Complications
Non-pancreatic periampullary cancer
Pancreatoduodenectomy
Tumor behavior
Descripción
Sumario: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.

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