Impact of extra-ampullary duodenal adenocarcinoma subtypes on surgical and oncological outcomes following pancreaticoduodenectomy

Background There is little information about the relevance of extra-ampullary duodenal adenocarcinoma (EDA) subtypes. The aim of this study was to evaluate the impact of EDA subtypes on surgical and oncological outcomes following pancreatoduodenectomy (PD). Methods Consecutive patients undergoing PD...

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Veröffentlicht in:Updates in surgery 2024, Vol.76 (1), p.87-95
Hauptverfasser: De Pastena, Matteo, Zingaretti, Caterina Costanza, Paiella, Salvatore, Guerriero, Massimo, De Santis, Nicoletta, Luchini, Claudio, Bassi, Claudio, Malleo, Giuseppe, Salvia, Roberto
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container_end_page 95
container_issue 1
container_start_page 87
container_title Updates in surgery
container_volume 76
creator De Pastena, Matteo
Zingaretti, Caterina Costanza
Paiella, Salvatore
Guerriero, Massimo
De Santis, Nicoletta
Luchini, Claudio
Bassi, Claudio
Malleo, Giuseppe
Salvia, Roberto
description Background There is little information about the relevance of extra-ampullary duodenal adenocarcinoma (EDA) subtypes. The aim of this study was to evaluate the impact of EDA subtypes on surgical and oncological outcomes following pancreatoduodenectomy (PD). Methods Consecutive patients undergoing PD for EDA from 2000 to 2019 were analyzed. Results were stratified by pathologic subtype (intestinal versus non-intestinal). Uni-and multivariable analyses were performed using standard statistical methods. Results The study population consisted of 70 patients, of whom 49 (70%) had an intestinal phenotype. EDA with intestinal phenotype was more frequently proximal to the Ampulla of Vater, while non-intestinal EDA was more frequently found distally (76% vs. 33%, p = 0.002). Patients with intestinal EDA were less likely to experience severe morbidity, with decreased reoperation and unplanned Intensive Care Unit admission rates relative to non-intestinal subtypes (2% vs. 29% p = 0.002, and 2% vs. 19%, p = 0.007, respectively). The median follow-up post-pancreatectomy was 73 months. Intestinal EDA was associated with improved overall and disease-free survival, with 3-year and 5-year survival rates of 71% vs. 29% and 53% vs. 24%, respectively. (p = 0.019 and p = 0.025). Conclusion Intestinal-type EDA, which more often arises from supra-ampullary duodenum, was associated with better postoperative outcomes and improved survival.
doi_str_mv 10.1007/s13304-023-01688-0
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The aim of this study was to evaluate the impact of EDA subtypes on surgical and oncological outcomes following pancreatoduodenectomy (PD). Methods Consecutive patients undergoing PD for EDA from 2000 to 2019 were analyzed. Results were stratified by pathologic subtype (intestinal versus non-intestinal). Uni-and multivariable analyses were performed using standard statistical methods. Results The study population consisted of 70 patients, of whom 49 (70%) had an intestinal phenotype. EDA with intestinal phenotype was more frequently proximal to the Ampulla of Vater, while non-intestinal EDA was more frequently found distally (76% vs. 33%, p = 0.002). Patients with intestinal EDA were less likely to experience severe morbidity, with decreased reoperation and unplanned Intensive Care Unit admission rates relative to non-intestinal subtypes (2% vs. 29% p = 0.002, and 2% vs. 19%, p = 0.007, respectively). The median follow-up post-pancreatectomy was 73 months. Intestinal EDA was associated with improved overall and disease-free survival, with 3-year and 5-year survival rates of 71% vs. 29% and 53% vs. 24%, respectively. (p = 0.019 and p = 0.025). Conclusion Intestinal-type EDA, which more often arises from supra-ampullary duodenum, was associated with better postoperative outcomes and improved survival.</description><identifier>ISSN: 2038-131X</identifier><identifier>EISSN: 2038-3312</identifier><identifier>DOI: 10.1007/s13304-023-01688-0</identifier><identifier>PMID: 38093152</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Adenocarcinoma - pathology ; Adenocarcinoma - surgery ; Ampulla of Vater - pathology ; Ampulla of Vater - surgery ; Common Bile Duct Neoplasms - pathology ; Common Bile Duct Neoplasms - surgery ; Duodenal Neoplasms - surgery ; Humans ; Medicine ; Medicine &amp; Public Health ; Original Article ; Pancreatic Neoplasms - surgery ; Pancreaticoduodenectomy ; Retrospective Studies ; Surgery</subject><ispartof>Updates in surgery, 2024, Vol.76 (1), p.87-95</ispartof><rights>Italian Society of Surgery (SIC) 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2023. Italian Society of Surgery (SIC).</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c347t-98b04070e244132004c4e4cfb164c719b1b2c76a5c25d34c1d647e9f6cad22ad3</citedby><cites>FETCH-LOGICAL-c347t-98b04070e244132004c4e4cfb164c719b1b2c76a5c25d34c1d647e9f6cad22ad3</cites><orcidid>0000-0001-5244-4357</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s13304-023-01688-0$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s13304-023-01688-0$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38093152$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>De Pastena, Matteo</creatorcontrib><creatorcontrib>Zingaretti, Caterina Costanza</creatorcontrib><creatorcontrib>Paiella, Salvatore</creatorcontrib><creatorcontrib>Guerriero, Massimo</creatorcontrib><creatorcontrib>De Santis, Nicoletta</creatorcontrib><creatorcontrib>Luchini, Claudio</creatorcontrib><creatorcontrib>Bassi, Claudio</creatorcontrib><creatorcontrib>Malleo, Giuseppe</creatorcontrib><creatorcontrib>Salvia, Roberto</creatorcontrib><title>Impact of extra-ampullary duodenal adenocarcinoma subtypes on surgical and oncological outcomes following pancreaticoduodenectomy</title><title>Updates in surgery</title><addtitle>Updates Surg</addtitle><addtitle>Updates Surg</addtitle><description>Background There is little information about the relevance of extra-ampullary duodenal adenocarcinoma (EDA) subtypes. The aim of this study was to evaluate the impact of EDA subtypes on surgical and oncological outcomes following pancreatoduodenectomy (PD). Methods Consecutive patients undergoing PD for EDA from 2000 to 2019 were analyzed. Results were stratified by pathologic subtype (intestinal versus non-intestinal). Uni-and multivariable analyses were performed using standard statistical methods. Results The study population consisted of 70 patients, of whom 49 (70%) had an intestinal phenotype. EDA with intestinal phenotype was more frequently proximal to the Ampulla of Vater, while non-intestinal EDA was more frequently found distally (76% vs. 33%, p = 0.002). Patients with intestinal EDA were less likely to experience severe morbidity, with decreased reoperation and unplanned Intensive Care Unit admission rates relative to non-intestinal subtypes (2% vs. 29% p = 0.002, and 2% vs. 19%, p = 0.007, respectively). The median follow-up post-pancreatectomy was 73 months. Intestinal EDA was associated with improved overall and disease-free survival, with 3-year and 5-year survival rates of 71% vs. 29% and 53% vs. 24%, respectively. (p = 0.019 and p = 0.025). Conclusion Intestinal-type EDA, which more often arises from supra-ampullary duodenum, was associated with better postoperative outcomes and improved survival.</description><subject>Adenocarcinoma - pathology</subject><subject>Adenocarcinoma - surgery</subject><subject>Ampulla of Vater - pathology</subject><subject>Ampulla of Vater - surgery</subject><subject>Common Bile Duct Neoplasms - pathology</subject><subject>Common Bile Duct Neoplasms - surgery</subject><subject>Duodenal Neoplasms - surgery</subject><subject>Humans</subject><subject>Medicine</subject><subject>Medicine &amp; Public Health</subject><subject>Original Article</subject><subject>Pancreatic Neoplasms - surgery</subject><subject>Pancreaticoduodenectomy</subject><subject>Retrospective Studies</subject><subject>Surgery</subject><issn>2038-131X</issn><issn>2038-3312</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kD1PwzAQhi0EolXhDzCgjCyB80fzMaKKL6kSC0hslnNxqlRJLtiJoCP_HJcURjzYd_Jzr-WHsQsO1xwgvfFcSlAxCBkDT7IshiM2FyCzWEoujg81l_xtxs6930JYMt_vp2wmM8glX4o5-3pqe4NDRFVkPwdnYtP2Y9MYt4vKkUrbmSYy4SA0DuuOWhP5sRh2vfURdaF2mxr3TFeGHqmhqadxQGoDVFHT0EfdbaLedOisGWqkKdriQO3ujJ1UpvH2_HAu2Ov93cvqMV4_PzytbtcxSpUOcZ4VoCAFK5TiUgAoVFZhVfBEYcrzghcC08QsUSxLqZCXiUptXiVoSiFMKRfsasrtHb2P1g-6rT3a8NfO0ui1yEHk4SmVBFRMKDry3tlK965ugxPNQe_t68m-Dvb1j30NYejykD8WrS3_Rn5dB0BOgA9X3cY6vaXRBcH-v9hvMDaTEw</recordid><startdate>2024</startdate><enddate>2024</enddate><creator>De Pastena, Matteo</creator><creator>Zingaretti, Caterina Costanza</creator><creator>Paiella, Salvatore</creator><creator>Guerriero, Massimo</creator><creator>De Santis, Nicoletta</creator><creator>Luchini, Claudio</creator><creator>Bassi, Claudio</creator><creator>Malleo, Giuseppe</creator><creator>Salvia, Roberto</creator><general>Springer International Publishing</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-5244-4357</orcidid></search><sort><creationdate>2024</creationdate><title>Impact of extra-ampullary duodenal adenocarcinoma subtypes on surgical and oncological outcomes following pancreaticoduodenectomy</title><author>De Pastena, Matteo ; Zingaretti, Caterina Costanza ; Paiella, Salvatore ; Guerriero, Massimo ; De Santis, Nicoletta ; Luchini, Claudio ; Bassi, Claudio ; Malleo, Giuseppe ; Salvia, Roberto</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c347t-98b04070e244132004c4e4cfb164c719b1b2c76a5c25d34c1d647e9f6cad22ad3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Adenocarcinoma - pathology</topic><topic>Adenocarcinoma - surgery</topic><topic>Ampulla of Vater - pathology</topic><topic>Ampulla of Vater - surgery</topic><topic>Common Bile Duct Neoplasms - pathology</topic><topic>Common Bile Duct Neoplasms - surgery</topic><topic>Duodenal Neoplasms - surgery</topic><topic>Humans</topic><topic>Medicine</topic><topic>Medicine &amp; Public Health</topic><topic>Original Article</topic><topic>Pancreatic Neoplasms - surgery</topic><topic>Pancreaticoduodenectomy</topic><topic>Retrospective Studies</topic><topic>Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>De Pastena, Matteo</creatorcontrib><creatorcontrib>Zingaretti, Caterina Costanza</creatorcontrib><creatorcontrib>Paiella, Salvatore</creatorcontrib><creatorcontrib>Guerriero, Massimo</creatorcontrib><creatorcontrib>De Santis, Nicoletta</creatorcontrib><creatorcontrib>Luchini, Claudio</creatorcontrib><creatorcontrib>Bassi, Claudio</creatorcontrib><creatorcontrib>Malleo, Giuseppe</creatorcontrib><creatorcontrib>Salvia, Roberto</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Updates in surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>De Pastena, Matteo</au><au>Zingaretti, Caterina Costanza</au><au>Paiella, Salvatore</au><au>Guerriero, Massimo</au><au>De Santis, Nicoletta</au><au>Luchini, Claudio</au><au>Bassi, Claudio</au><au>Malleo, Giuseppe</au><au>Salvia, Roberto</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of extra-ampullary duodenal adenocarcinoma subtypes on surgical and oncological outcomes following pancreaticoduodenectomy</atitle><jtitle>Updates in surgery</jtitle><stitle>Updates Surg</stitle><addtitle>Updates Surg</addtitle><date>2024</date><risdate>2024</risdate><volume>76</volume><issue>1</issue><spage>87</spage><epage>95</epage><pages>87-95</pages><issn>2038-131X</issn><eissn>2038-3312</eissn><abstract>Background There is little information about the relevance of extra-ampullary duodenal adenocarcinoma (EDA) subtypes. The aim of this study was to evaluate the impact of EDA subtypes on surgical and oncological outcomes following pancreatoduodenectomy (PD). Methods Consecutive patients undergoing PD for EDA from 2000 to 2019 were analyzed. Results were stratified by pathologic subtype (intestinal versus non-intestinal). Uni-and multivariable analyses were performed using standard statistical methods. Results The study population consisted of 70 patients, of whom 49 (70%) had an intestinal phenotype. EDA with intestinal phenotype was more frequently proximal to the Ampulla of Vater, while non-intestinal EDA was more frequently found distally (76% vs. 33%, p = 0.002). Patients with intestinal EDA were less likely to experience severe morbidity, with decreased reoperation and unplanned Intensive Care Unit admission rates relative to non-intestinal subtypes (2% vs. 29% p = 0.002, and 2% vs. 19%, p = 0.007, respectively). The median follow-up post-pancreatectomy was 73 months. Intestinal EDA was associated with improved overall and disease-free survival, with 3-year and 5-year survival rates of 71% vs. 29% and 53% vs. 24%, respectively. (p = 0.019 and p = 0.025). Conclusion Intestinal-type EDA, which more often arises from supra-ampullary duodenum, was associated with better postoperative outcomes and improved survival.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>38093152</pmid><doi>10.1007/s13304-023-01688-0</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0001-5244-4357</orcidid></addata></record>
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subjects Adenocarcinoma - pathology
Adenocarcinoma - surgery
Ampulla of Vater - pathology
Ampulla of Vater - surgery
Common Bile Duct Neoplasms - pathology
Common Bile Duct Neoplasms - surgery
Duodenal Neoplasms - surgery
Humans
Medicine
Medicine & Public Health
Original Article
Pancreatic Neoplasms - surgery
Pancreaticoduodenectomy
Retrospective Studies
Surgery
title Impact of extra-ampullary duodenal adenocarcinoma subtypes on surgical and oncological outcomes following pancreaticoduodenectomy
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