Cancers (Feb 2024)
Different Periampullary Types and Subtypes Leading to Different Perioperative Outcomes of Pancreatoduodenectomy: Reality and Not a Myth; An International Multicenter Cohort Study
- Bas A. Uijterwijk,
- Daniël H. Lemmers,
- Giuseppe Kito Fusai,
- Bas Groot Koerkamp,
- Sharnice Koek,
- Alessandro Zerbi,
- Ernesto Sparrelid,
- Ugo Boggi,
- Misha Luyer,
- Benedetto Ielpo,
- Roberto Salvia,
- Brian K. P. Goh,
- Geert Kazemier,
- Bergthor Björnsson,
- Mario Serradilla-Martín,
- Michele Mazzola,
- Vasileios K. Mavroeidis,
- Santiago Sánchez-Cabús,
- Patrick Pessaux,
- Steven White,
- Adnan Alseidi,
- Raffaele Dalla Valle,
- Dimitris Korkolis,
- Louisa R. Bolm,
- Zahir Soonawalla,
- Keith J. Roberts,
- Miljana Vladimirov,
- Alessandro Mazzotta,
- Jorg Kleeff,
- Miguel Angel Suarez Muñoz,
- Marc G. Besselink,
- Mohammed Abu Hilal
Affiliations
- Bas A. Uijterwijk
- Department of Surgery, Fondazione Poliambulanza, 25124 Brescia, Italy
- Daniël H. Lemmers
- Department of Surgery, Fondazione Poliambulanza, 25124 Brescia, Italy
- Giuseppe Kito Fusai
- Department of Surgery, Royal Free London NHS Foundation Trust, London NW3 2QG, UK
- Bas Groot Koerkamp
- Erasmus MC, 3015 Rotterdam, The Netherlands
- Sharnice Koek
- Department of Surgery, Fiona Stanley Hospital, Murdoch, WA 6150, Australia
- Alessandro Zerbi
- Department of Pancreatic Surgery, IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy
- Ernesto Sparrelid
- Division of Surgery, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Karolinska University Hospital, 171 64 Solna, Sweden
- Ugo Boggi
- Department of Surgery, Pisa University Hospital, 56100 Pisa, Italy
- Misha Luyer
- Department of Surgery, Catharina Hospital Eindhoven, 5623 Eindhoven, The Netherlands
- Benedetto Ielpo
- Department of Surgery, Hospital del Mar, 08003 Barcelona, Spain
- Roberto Salvia
- Department of Surgery, University Hospital of Verona, 37126 Verona, Italy
- Brian K. P. Goh
- Department of Hepatopancreatobilliary and Transplant Surgery, National Cancer Centre, Singapore General Hospital, Singapore 168583, Singapore
- Geert Kazemier
- Department of Surgery, Amsterdam UMC, Location VUmc, 1007 Amsterdam, The Netherlands
- Bergthor Björnsson
- Department of Surgery in Linköping, Department of Biomedical and Clinical Sciences, Linköping University, 581 83 Linköping, Sweden
- Mario Serradilla-Martín
- Department of Surgery, Miguel Servet University Hospital, 50009 Zaragoza, Spain
- Michele Mazzola
- Division of Oncologic and Mini-Invasive General Surgery, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milan, Italy
- Vasileios K. Mavroeidis
- Department of Academic Surgery, The Royal Marsden Hospital, London SW3 6JJ, UK
- Santiago Sánchez-Cabús
- Department of Surgery, Hospital de Sant Pau, 08025 Barcelona, Spain
- Patrick Pessaux
- Hepatobiliary and Pancreatic Surgical Unit, Nouvel Hôpital Civil (NHC), 67000 Strasbourg, France
- Steven White
- Department of Surgery, Newcastle Upon Tyne Hospitals, NHS Foundation Trust, Newcastle Upon Tyne NE3 3HD, UK
- Adnan Alseidi
- Department of Surgery, Virginia Mason, Seattle, WA 98101, USA
- Raffaele Dalla Valle
- Department of Surgery, University Hospital of Parma, 43126 Parma, Italy
- Dimitris Korkolis
- Department of Surgery, Hellenic Anticancer Hospital ‘Saint Savvas’, 115 22 Athens, Greece
- Louisa R. Bolm
- Department of Surgery, University Medical Center Schleswig-Holstein, Campus Lübeck, 23538 Lübeck, Germany
- Zahir Soonawalla
- Department of Hepatobiliary and Pancreatic Surgery, Oxford University Hospitals, NHS Foundation Trust, Oxford OX3 9DU, UK
- Keith J. Roberts
- Faculty of Medicine, University of Birmingham, Birmingham B15 2TT, UK
- Miljana Vladimirov
- Department of Surgery Hospital Nuremberg, PMU Nürnberg, 90419 Nürnberg, Germany
- Alessandro Mazzotta
- Department of Digestive, Oncologic and Metabolic Surgery, Institut Mutualiste Montsouris, 75014 Paris, France
- Jorg Kleeff
- Department of Surgery, Martin-Luther University Halle-Wittenberg, 06108 Halle (Saale), Germany
- Miguel Angel Suarez Muñoz
- Department of Surgery, University Hospital Virgen de la Victoria, 29010 Malaga, Spain
- Marc G. Besselink
- Department of Surgery, Amsterdam UMC, University of Amsterdam, 1012 Amsterdam, The Netherlands
- Mohammed Abu Hilal
- Department of Surgery, Fondazione Poliambulanza, 25124 Brescia, Italy
- DOI
- https://doi.org/10.3390/cancers16050899
- Journal volume & issue
-
Vol. 16,
no. 5
p. 899
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 p = 0.001) and PDAC (8.3%, p 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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