Annals of Gastroenterological Surgery (Sep 2024)
Is multidisciplinary treatment effective for invasive intraductal papillary mucinous carcinoma?
- Seiko Hirono,
- Ryota Higuchi,
- Goro Honda,
- Satoshi Nara,
- Minoru Esaki,
- Naoto Gotohda,
- Hideki Takami,
- Michiaki Unno,
- Teiichi Sugiura,
- Masayuki Ohtsuka,
- Yasuhiro Shimizu,
- Ippei Matsumoto,
- Toshifumi Kin,
- Hiroyuki Isayama,
- Daisuke Hashimoto,
- Yasuji Seyama,
- Hiroaki Nagano,
- Kenichi Hakamada,
- Satoshi Hirano,
- Yuichi Nagakawa,
- Shugo Mizuno,
- Hidenori Takahashi,
- Kazuto Shibuya,
- Hideki Sasanuma,
- Taku Aoki,
- Yuichiro Kohara,
- Toshiki Rikiyama,
- Masafumi Nakamura,
- Itaru Endo,
- Yoshihiro Sakamoto,
- Akihiko Horiguchi,
- Takashi Hatori,
- Hirofumi Akita,
- Toshiharu Ueki,
- Tetsuya Idichi,
- Keiji Hanada,
- Shuji Suzuki,
- Keiichi Okano,
- Hiromitsu Maehira,
- Fuyuhiko Motoi,
- Yasuhiro Fujino,
- Satoshi Tanno,
- Akio Yanagisawa,
- Yoshifumi Takeyama,
- Kazuichi Okazaki,
- Sohei Satoi,
- Hiroki Yamaue
Affiliations
- Seiko Hirono
- Second Department of Surgery Wakayama Medical University, School of Medicine Wakayama Japan
- Ryota Higuchi
- Department of Surgery, Institute of Gastroenterology Tokyo Women's Medical University Tokyo Japan
- Goro Honda
- Department of Surgery, Institute of Gastroenterology Tokyo Women's Medical University Tokyo Japan
- Satoshi Nara
- Department of Hepatobiliary and Pancreatic Surgery National Cancer Center Hospital Tokyo Japan
- Minoru Esaki
- Department of Hepatobiliary and Pancreatic Surgery National Cancer Center Hospital Tokyo Japan
- Naoto Gotohda
- Department of Hepatobiliary and Pancreatic Surgery National Cancer Center Hospital East Kashiwa Japan
- Hideki Takami
- Department of Gastroenterological Surgery Nagoya University Graduate School of Medicine Nagoya Japan
- Michiaki Unno
- Department of Surgery Tohoku University Graduate School of Medicine Sendai Japan
- Teiichi Sugiura
- Division of Hepato‐Biliary‐Pancreatic Surgery Shizuoka Cancer Center Shizuoka Japan
- Masayuki Ohtsuka
- Department of General Surgery Chiba University, Graduate School of Medicine Chiba Japan
- Yasuhiro Shimizu
- Department of Gastroenterological Surgery Aichi Cancer Center Hospital Nagoya Japan
- Ippei Matsumoto
- Division of Hepato‐Biliary‐Pancreatic Surgery, Department of Surgery Kindai University Faculty of Medicine Osakasayama Japan
- Toshifumi Kin
- Teine Keijinkai Hospital Sapporo Japan
- Hiroyuki Isayama
- Department of Gastroenterology, Graduate School of Medicine Juntendo University Tokyo Japan
- Daisuke Hashimoto
- Department of Surgery Kansai Medical University Hirakata Japan
- Yasuji Seyama
- Department of Hepato‐Biliary‐Pancreatic Surgery Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital Tokyo Japan
- Hiroaki Nagano
- Department of Gastroenterological Breast and Endocrine Surgery Yamaguchi University Graduate Medicine Ube Japan
- Kenichi Hakamada
- Department of Gastroenterological Surgery Hirosaki University Graduate School of Medicine Hirosaki Japan
- Satoshi Hirano
- Department of Gastroenterological Surgery II Hokkaido University Faculty of Medicine Sapporo Japan
- Yuichi Nagakawa
- Department of Gastrointestinal and Pediatric Surgery Tokyo Medical University Tokyo Japan
- Shugo Mizuno
- Department of Hepatobiliary Pancreatic & Transplant Surgery Mie University Tsu Japan
- Hidenori Takahashi
- Department of Gastroenterological Surgery, Graduate School of Medicine Osaka University Suita Japan
- Kazuto Shibuya
- Department of Surgery and Science, Faculty of Medicine, Academic Assembly University of Toyama Toyama Japan
- Hideki Sasanuma
- Department of Surgery Jichi Medical University Shimotsuke Japan
- Taku Aoki
- Department of Hepato‐Biliary‐Pancreatic Surgery Dokkyo Medical University Mibu Japan
- Yuichiro Kohara
- Department of Surgery Nara Medical University Kashiwara Japan
- Toshiki Rikiyama
- Department of Surgery, Saitama Medical Center Jichi Medical University Saitama Japan
- Masafumi Nakamura
- Department of Surgery and Oncology, Graduate School of Medical Sciences Kyushu University Fukuoka Japan
- Itaru Endo
- Department of Gastroenterological Surgery Yokohama City University School of Medicine Yokohama Japan
- Yoshihiro Sakamoto
- Department of Hepato‐Biliary‐Pancreatic Surgery Kyorin University Hospital Mitaka Japan
- Akihiko Horiguchi
- Department of Gastroenterological Surgery Fujita Health University School of Medicine, Bantane Hospital Nagoya Japan
- Takashi Hatori
- Digestive Disease Center, International University of Health and Welfare Mita Hospital Tokyo Japan
- Hirofumi Akita
- Osaka International Cancer Institute Department of Gasteroenterological Sugery Osaka Japan
- Toshiharu Ueki
- Department of Gastroenterology Fukuoka University Chikushi Hospital Fukuoka Japan
- Tetsuya Idichi
- Department of Digestive Surgery Kagoshima University Kagoshima Japan
- Keiji Hanada
- Department of Gastroenterology Onomichi General Hospital Onomichi Japan
- Shuji Suzuki
- Department of Gastroenterological Surgery, Ibaraki Medical Center Tokyo Medical University Ineshiki Japan
- Keiichi Okano
- Department of Gastroenterological Surgery Kagawa University Kida Japan
- Hiromitsu Maehira
- Department of Surgery Shiga University of Medical Science Otsu Japan
- Fuyuhiko Motoi
- Department of Surgery I Yamagata University Yamagata Japan
- Yasuhiro Fujino
- Department of Gastroenterological Surgery Hyogo Cancer Center Akashi Japan
- Satoshi Tanno
- Department of Gastroenterology IMS Sapporo Digestive Disease Central General Hospital Sapporo Japan
- Akio Yanagisawa
- Department of Pathology Japanese Red Cross Kyoto Daiichi Hospital Kamigyo‐ku Japan
- Yoshifumi Takeyama
- Division of Hepato‐Biliary‐Pancreatic Surgery, Department of Surgery Kindai University Faculty of Medicine Osakasayama Japan
- Kazuichi Okazaki
- Kansai Medical University Kouri Hospital Neyagawa Japan
- Sohei Satoi
- Department of Surgery Kansai Medical University Hirakata Japan
- Hiroki Yamaue
- Second Department of Surgery Wakayama Medical University, School of Medicine Wakayama Japan
- DOI
- https://doi.org/10.1002/ags3.12790
- Journal volume & issue
-
Vol. 8,
no. 5
pp. 845 – 859
Abstract
Abstract Background Surgical resection is standard treatment for invasive intraductal papillary mucinous carcinoma (IPMC); however, impact of multidisciplinary treatment on survival including postoperative adjuvant therapy (AT), neoadjuvant therapy (NAT), and treatment for recurrent lesions is unclear. We investigated the effectiveness of multidisciplinary treatment in prolonging survival of patients with invasive IPMC. Methods This retrospective multi‐institutional study included 1183 patients with invasive IPMC undergoing surgery at 40 academic institutions. We analyzed the effects of AT, NAT, and treatment for recurrence on survival of patients with invasive IPMC. Results Completion of the planned postoperative AT for 6 months improved the overall survival (OS), disease‐specific survival (DSS), and recurrence‐free survival (RFS) of patients with stage IIB and stage III resected invasive IPMC, elevated preoperative carbohydrate antigen 19–9 level, lymphovascular invasion, perineural invasion, serosal invasion, and lymph node metastasis on un‐matched and matched analyses. Of the patients with borderline resectable (BR) invasive IPMC, the OS (p = 0.001), DSS (p = 0.001), and RFS (p = 0.001) of patients undergoing NAT was longer than that of those without on the matched analysis. Of the 484 invasive IPMC patients (40.9%) who developed recurrence after surgery, the OS of 365 patients who received any treatment for recurrence was longer than that of those without treatment (40.6 vs. 22.4 months, p < 0.001). Conclusion Postoperative AT might benefit selected patients with invasive IPMC, especially those at high risk of poor survival. NAT might improve the survivability of BR invasive IPMC. Any treatment for recurrence after surgery for invasive IPMC might improve survival.
Keywords
- invasive IPMC
- multidisciplinary treatment
- neoadjuvant therapy
- postoperative adjuvant therapy
- recurrence
