Intra-pancreatic distal cholangiocarcinoma and pancreatic ductal adenocarcinoma: a common short and long-term prognosis?
Autor: | Oyekashopefoluw Alao, Vincent Moutardier, Stéphane Berdah, David Jérémie Birnbaum, Ghislain Schlienger, O. Risse, Mircea Chirica, Théophile Guilbaud, Edouard Girard, Coralie Lemoine |
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Rok vydání: | 2021 |
Předmět: |
medicine.medical_specialty
Pancreatic ductal adenocarcinoma medicine.medical_treatment 030230 surgery Gastroenterology Pancreaticoduodenectomy Cholangiocarcinoma 03 medical and health sciences 0302 clinical medicine Internal medicine Overall survival Humans Medicine Lymph node Retrospective Studies Pancreatic duct business.industry Pancreatic Ducts Prognosis medicine.disease digestive system diseases Surgery Pancreatic Neoplasms Survival Rate Bile Ducts Intrahepatic medicine.anatomical_structure Bile Duct Neoplasms Pancreatic fistula 030220 oncology & carcinogenesis Resection margin Severe morbidity business Carcinoma Pancreatic Ductal |
Zdroj: | Updates in Surgery. 73:439-450 |
ISSN: | 2038-3312 2038-131X |
DOI: | 10.1007/s13304-021-00981-0 |
Popis: | The aim of the study was to compare histological features, postoperative outcomes, and long-term prognostic factors after pancreaticoduodenectomy for distal cholangiocarcinoma and pancreatic ductal adenocarcinoma. From 2005 to 2017, 188 pancreaticoduodenectomies (pancreatic ductal adenocarcinoma n = 151, distal cholangiocarcinoma n = 37) were included. Postoperative outcomes were compared after matching on pancreatic gland texture and main pancreatic duct size. Matching according to tumor size, lymph node invasion and resection margin was used to compare overall and disease-free survival. Distal cholangiocarcinoma patients had more often “soft” pancreatic gland (P = 0.002) and small size main pancreatic duct (P = 0.001). Pancreatic ductal adenocarcinoma patients had larger tumors (P = 0.009), and higher lymph node ratio (P = 0.017). Severe morbidity (P = 0.023) and clinically relevant pancreatic fistula (P = 0.018) were higher in distal cholangiocarcinoma patients. After matching on gland texture and main pancreatic duct diameter, clinically relevant postoperative pancreatic fistula was still more frequent in distal cholangiocarcinoma patients (P = 0.007). Tumor size > 20 mm was predictive of impaired overall survival (P = 0.024) and disease-free survival (P = 0.003), tumor differentiation (P = 0.027) was predictive of impaired overall survival. Survival outcomes for distal cholangiocarcinoma and pancreatic ductal cholangiocarcinoma were similar after matching patients according to tumor size, lymph node invasion and resection margin. Long-term outcomes after pancreaticoduodenectomy for distal cholangiocarcinoma and pancreatic ductal adenocarcinoma patients are similar. Postoperative course is more complicated after pancreaticoduodenectomy for distal cholangiocarcinoma than pancreatic ductal adenocarcinoma. After pancreaticoduodenectomy, patients with distal cholangiocarcinoma and pancreatic ductal adenocarcinoma have similar long-term oncological outcomes. |
Databáze: | OpenAIRE |
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