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 |
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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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fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2902934746</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2902934746</sourcerecordid><originalsourceid>FETCH-LOGICAL-c347t-98b04070e244132004c4e4cfb164c719b1b2c76a5c25d34c1d647e9f6cad22ad3</originalsourceid><addsrcrecordid>eNp9kD1PwzAQhi0EolXhDzCgjCyB80fzMaKKL6kSC0hslnNxqlRJLtiJoCP_HJcURjzYd_Jzr-WHsQsO1xwgvfFcSlAxCBkDT7IshiM2FyCzWEoujg81l_xtxs6930JYMt_vp2wmM8glX4o5-3pqe4NDRFVkPwdnYtP2Y9MYt4vKkUrbmSYy4SA0DuuOWhP5sRh2vfURdaF2mxr3TFeGHqmhqadxQGoDVFHT0EfdbaLedOisGWqkKdriQO3ujJ1UpvH2_HAu2Ov93cvqMV4_PzytbtcxSpUOcZ4VoCAFK5TiUgAoVFZhVfBEYcrzghcC08QsUSxLqZCXiUptXiVoSiFMKRfsasrtHb2P1g-6rT3a8NfO0ui1yEHk4SmVBFRMKDry3tlK965ugxPNQe_t68m-Dvb1j30NYejykD8WrS3_Rn5dB0BOgA9X3cY6vaXRBcH-v9hvMDaTEw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2902934746</pqid></control><display><type>article</type><title>Impact of extra-ampullary duodenal adenocarcinoma subtypes on surgical and oncological outcomes following pancreaticoduodenectomy</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>De Pastena, Matteo ; Zingaretti, Caterina Costanza ; Paiella, Salvatore ; Guerriero, Massimo ; De Santis, Nicoletta ; Luchini, Claudio ; Bassi, Claudio ; Malleo, Giuseppe ; Salvia, Roberto</creator><creatorcontrib>De Pastena, Matteo ; Zingaretti, Caterina Costanza ; Paiella, Salvatore ; Guerriero, Massimo ; De Santis, Nicoletta ; Luchini, Claudio ; Bassi, Claudio ; Malleo, Giuseppe ; Salvia, Roberto</creatorcontrib><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><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 & 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 & 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 & 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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