The Five Periampullary Cancers, not Just Different Siblings but Different Families: An International Multicenter Cohort Study.

Autor: Uijterwijk BA; Department of Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.; Cancer Center Amsterdam, Amsterdam, The Netherlands., Lemmers DH; Department of Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.; Cancer Center Amsterdam, Amsterdam, The Netherlands., Ghidini M; Department of Medical Oncology, Policlinico di Milano, Fondazione IRCCS Ca' Granda, Milano, Italy., Wilmink H; Department of Medical Oncology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands., Zaniboni A; Department of Medical Oncology, Fondazione Poliambulanza, Brescia, Italy., Salvia R; Department of General and Pancreatic Surgery, Pancreas Institute, University of Verona Hospital Trust, Verona, Italy., Kito Fusai G; Department of Surgery, Royal Free London NHS Foundation Trust, London, UK., Groot Koerkamp B; Department of Surgery, Erasmus MC Cancer Institute, Rotterdam, The Netherlands., Koek S; Department of Surgery, Fiona Stanley Hospital, Perth, Australia., Ghorbani P; Division of Surgery, Department of Clinical Science, Intervention and Technology, Karolinska Institutet at Karolinska University Hospital, Stockholm, Sweden., Zerbi A; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy.; Pancreatic Surgery, IRCCS Humanitas Research Hospital, Rozzano, Italy., Nappo G; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy.; Pancreatic Surgery, IRCCS Humanitas Research Hospital, Rozzano, Italy., Luyer M; Department of Surgery, Catharina Hospital Eindhoven, Eindhoven, The Netherlands., Goh BKP; Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital, Duke-National University of Singapore, Singapore, Singapore., Roberts KJ; Faculty of Medicine, University of Birmingham, Birmingham, UK., Boggi U; Department of Surgery, Pisa University Hospital, Pisa, Italy., Mavroeidis VK; Department of Academic Surgery, The Royal Marsden Hospital, London, UK.; Department of Hepatobiliary and Pancreatic Surgery, Oxford University Hospitals NHS Foundation Trust, Oxford, UK., White S; Department of Surgery, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle, UK., Kazemier G; Department of Surgery, Amsterdam UMC, VUmc, Amsterdam, The Netherlands., Björnsson B; Department of Surgery, Linköping University Hospital, Linköping, Sweden., Serradilla-Martín M; Department of Surgery, Miguel Servet University Hospital, Zaragoza, Spain., House MG; Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA., Alseidi A; Department of Surgery, Virginia Mason, Seattle, WA, USA., Ielpo B; Hospital del Mar, Barcelona, Spain., Mazzola M; Division of Oncologic and Mini-invasive General Surgery, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy., Jamieson N; West of Scotland Pancreatic Unit, Glasgow Royal Infirmary, Glasgow, UK., Wellner U; Department of Surgery, University Medical Center Schleswig-Holstein, Lübeck, Germany., Soonawalla Z; Department of Hepatobiliary and Pancreatic Surgery, Oxford University Hospitals NHS Foundation Trust, Oxford, UK., Cabús SS; Department of Surgery, Hospital de Sant Pau, Barcelona, Spain., Dalla Valle R; Department of Surgery, University Hospital of Parma, Parma, Italy., Pessaux P; Hepatobiliary and Pancreatic Surgical Unit, Nouvel Hôpital Civil (NHC), Strasbourg, France., Vladimirov M; Department of Surgery, Paracelsus Medical Private University (PMU, Nuremberg, Germany., Kent TS; Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA., Tang CN; Department of Surgery, Pamela Youde Nethersole Eastern Hospital, Hong Kong, China., Fisher WE; Department of Surgery, Baylor College of Medicine, Houston, TX, USA., Kleeff J; Department of Surgery, Martin-Luther University Halle-Wittenberg, Halle (Saale), Germany., Mazzotta A; Department of Digestive, Oncologic and Metabolic Surgery, Institut Mutualiste Montsouris, Paris, France., Suarez Muñoz MA; University Hospital Virgen de la Victoria, Malaga, Spain., Berger AC; Department of Surgery, Jefferson Medical College, Philadelphia, PA, USA., Ball CG; Department of Surgery, University of Calgary, Calgary, Alberta, Canada., Korkolis D; Hellenic Anticancer Hospital 'Saint Savvas', Athens, Greece., Bannone E; Department of Hepato-Biliary and Pancreatic Surgery, Istituto Fondazione Poliambulanza, Brescia, Italy., Ferarri C; Department of Hepato-Biliary and Pancreatic Surgery, Istituto Fondazione Poliambulanza, Brescia, Italy., Besselink MG; Department of Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.; Cancer Center Amsterdam, Amsterdam, The Netherlands., Abu Hilal M; Department of Hepato-Biliary and Pancreatic Surgery, Istituto Fondazione Poliambulanza, Brescia, Italy. abuhilal9@gmail.com.
Jazyk: angličtina
Zdroj: Annals of surgical oncology [Ann Surg Oncol] 2024 Sep; Vol. 31 (9), pp. 6157-6169. Date of Electronic Publication: 2024 Jun 18.
DOI: 10.1245/s10434-024-15555-8
Abstrakt: Background: Cancer arising in the periampullary region can be anatomically classified in pancreatic ductal adenocarcinoma (PDAC), distal cholangiocarcinoma (dCCA), duodenal adenocarcinoma (DAC), and ampullary carcinoma. Based on histopathology, ampullary carcinoma is currently subdivided in intestinal (AmpIT), pancreatobiliary (AmpPB), and mixed subtypes. Despite close anatomical resemblance, it is unclear how ampullary subtypes relate to the remaining periampullary cancers in tumor characteristics and behavior.
Methods: This international cohort study included patients after curative intent resection for periampullary cancer retrieved from 44 centers (from Europe, United States, Asia, Australia, and Canada) between 2010 and 2021. Preoperative CA19-9, pathology outcomes and 8-year overall survival were compared between DAC, AmpIT, AmpPB, dCCA, and PDAC.
Results: Overall, 3809 patients were analyzed, including 348 DAC, 774 AmpIT, 848 AmpPB, 1,036 dCCA, and 803 PDAC. The highest 8-year overall survival was found in patients with AmpIT and DAC (49.8% and 47.9%), followed by AmpPB (34.9%, P < 0.001), dCCA (26.4%, P  =  0.020), and finally PDAC (12.9%, P < 0.001). A better survival was correlated with lower CA19-9 levels but not with tumor size, as DAC lesions showed the largest size.
Conclusions: Despite close anatomic relations of the five periampullary cancers, this study revealed differences in preoperative blood markers, pathology, and long-term survival. More tumor characteristics are shared between DAC and AmpIT and between AmpPB and dCCA than between the two ampullary subtypes. Instead of using collective definitions for "periampullary cancers" or anatomical classification, this study emphasizes the importance of individual evaluation of each histopathological subtype with the ampullary subtypes as individual entities in future studies.
(© 2024. Society of Surgical Oncology.)
Databáze: MEDLINE
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