Recurrence rate and management after endoscopic papillectomy in a tertiary referral center
Endoscopic papillectomy (EP) is considered a safe procedure for ampullary lesions. Few data are available on management of residual and recurrent adenomas. The aims of the present study were to evaluate long-term recurrence rate, median time-to-recurrence after EP and treatment of both residual and...
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| Veröffentlicht in: | Digestive and liver disease 2024-12, Vol.56 (12), p.2143-2148 |
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| container_title | Digestive and liver disease |
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| creator | Dioscoridi, Lorenzo Donnarumma, Durante Forti, Edoardo Pugliese, Francesco Cintolo, Marcello Bonato, Giulia Bravo, Marianna Palermo, Andrea Mutignani, Massimiliano |
| description | Endoscopic papillectomy (EP) is considered a safe procedure for ampullary lesions. Few data are available on management of residual and recurrent adenomas. The aims of the present study were to evaluate long-term recurrence rate, median time-to-recurrence after EP and treatment of both residual and recurrent adenomas.
Consecutive patients who underwent EP of major and minor papilla at our endoscopy center between 2011 and 2022 were enrolled. Residual adenoma was defined as the endoscopic evidence of adenomatous tissue after EP. Recurrent adenoma was defined as the presence of adenomatous tissue after the first endoscopic follow-up and complete adenoma resection.
95 patients satisfied the inclusion criteria. Pathology after resection showed adenoma with low-grade dysplasia (LGD) in 52 patients, high-grade dysplasia (HGD) in 25 patients, adenocarcinoma in 6 patients, NET in 4 patients and not-neoplastic duodenal mucosa in 8 patients. Adverse events occurred in 25 % of patients. The median follow-up after EP was 22.5 months. Local residual was observed in 27 patients (28,4 %) and recurrence after the endoscopic retreatments occurred in 11 patients (11,6 %). Furthermore, recurrence occurred in 16 of 68 patients with adenoma-free after a first endoscopic follow-up and 9 patients developed at least a second recurrence. All the recurrences but one were endoscopically treated.
EP and its ancillary treatments for residual and recurrent adenomas is an effective treatment for ampullary tumors. Long-term surveillance demonstrates that recurrences can be mainly treated endoscopically. |
| doi_str_mv | 10.1016/j.dld.2024.04.037 |
| format | Article |
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Consecutive patients who underwent EP of major and minor papilla at our endoscopy center between 2011 and 2022 were enrolled. Residual adenoma was defined as the endoscopic evidence of adenomatous tissue after EP. Recurrent adenoma was defined as the presence of adenomatous tissue after the first endoscopic follow-up and complete adenoma resection.
95 patients satisfied the inclusion criteria. Pathology after resection showed adenoma with low-grade dysplasia (LGD) in 52 patients, high-grade dysplasia (HGD) in 25 patients, adenocarcinoma in 6 patients, NET in 4 patients and not-neoplastic duodenal mucosa in 8 patients. Adverse events occurred in 25 % of patients. The median follow-up after EP was 22.5 months. Local residual was observed in 27 patients (28,4 %) and recurrence after the endoscopic retreatments occurred in 11 patients (11,6 %). Furthermore, recurrence occurred in 16 of 68 patients with adenoma-free after a first endoscopic follow-up and 9 patients developed at least a second recurrence. All the recurrences but one were endoscopically treated.
EP and its ancillary treatments for residual and recurrent adenomas is an effective treatment for ampullary tumors. Long-term surveillance demonstrates that recurrences can be mainly treated endoscopically.</description><identifier>ISSN: 1590-8658</identifier><identifier>ISSN: 1878-3562</identifier><identifier>EISSN: 1878-3562</identifier><identifier>DOI: 10.1016/j.dld.2024.04.037</identifier><identifier>PMID: 38760239</identifier><language>eng</language><publisher>Netherlands: Elsevier Ltd</publisher><subject>Adenoma - pathology ; Adenoma - surgery ; Adult ; Aged ; Aged, 80 and over ; Ampulla of Vater - pathology ; Ampulla of Vater - surgery ; Ampulloma ; Common Bile Duct Neoplasms - pathology ; Common Bile Duct Neoplasms - surgery ; Endoscopic papillectomy ; ERCP ; Female ; Humans ; Intraductal radiofrequency ; Male ; Middle Aged ; Neoplasm Recurrence, Local - surgery ; Papillary neoplasm ; Retrospective Studies ; Sphincterotomy, Endoscopic - methods ; Tertiary Care Centers</subject><ispartof>Digestive and liver disease, 2024-12, Vol.56 (12), p.2143-2148</ispartof><rights>2024 Editrice Gastroenterologica Italiana S.r.l.</rights><rights>Copyright © 2024 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c305t-67ac35e8f1cf2bc2e712395891ec98d633e067ab4beed05fbc14a571de019f4c3</cites><orcidid>0000-0003-4975-018X ; 0009-0008-3555-6865 ; 0000-0001-8057-9398</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.dld.2024.04.037$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,778,782,3539,27907,27908,45978</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38760239$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Dioscoridi, Lorenzo</creatorcontrib><creatorcontrib>Donnarumma, Durante</creatorcontrib><creatorcontrib>Forti, Edoardo</creatorcontrib><creatorcontrib>Pugliese, Francesco</creatorcontrib><creatorcontrib>Cintolo, Marcello</creatorcontrib><creatorcontrib>Bonato, Giulia</creatorcontrib><creatorcontrib>Bravo, Marianna</creatorcontrib><creatorcontrib>Palermo, Andrea</creatorcontrib><creatorcontrib>Mutignani, Massimiliano</creatorcontrib><title>Recurrence rate and management after endoscopic papillectomy in a tertiary referral center</title><title>Digestive and liver disease</title><addtitle>Dig Liver Dis</addtitle><description>Endoscopic papillectomy (EP) is considered a safe procedure for ampullary lesions. Few data are available on management of residual and recurrent adenomas. The aims of the present study were to evaluate long-term recurrence rate, median time-to-recurrence after EP and treatment of both residual and recurrent adenomas.
Consecutive patients who underwent EP of major and minor papilla at our endoscopy center between 2011 and 2022 were enrolled. Residual adenoma was defined as the endoscopic evidence of adenomatous tissue after EP. Recurrent adenoma was defined as the presence of adenomatous tissue after the first endoscopic follow-up and complete adenoma resection.
95 patients satisfied the inclusion criteria. Pathology after resection showed adenoma with low-grade dysplasia (LGD) in 52 patients, high-grade dysplasia (HGD) in 25 patients, adenocarcinoma in 6 patients, NET in 4 patients and not-neoplastic duodenal mucosa in 8 patients. Adverse events occurred in 25 % of patients. The median follow-up after EP was 22.5 months. Local residual was observed in 27 patients (28,4 %) and recurrence after the endoscopic retreatments occurred in 11 patients (11,6 %). Furthermore, recurrence occurred in 16 of 68 patients with adenoma-free after a first endoscopic follow-up and 9 patients developed at least a second recurrence. All the recurrences but one were endoscopically treated.
EP and its ancillary treatments for residual and recurrent adenomas is an effective treatment for ampullary tumors. Long-term surveillance demonstrates that recurrences can be mainly treated endoscopically.</description><subject>Adenoma - pathology</subject><subject>Adenoma - surgery</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Ampulla of Vater - pathology</subject><subject>Ampulla of Vater - surgery</subject><subject>Ampulloma</subject><subject>Common Bile Duct Neoplasms - pathology</subject><subject>Common Bile Duct Neoplasms - surgery</subject><subject>Endoscopic papillectomy</subject><subject>ERCP</subject><subject>Female</subject><subject>Humans</subject><subject>Intraductal radiofrequency</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Neoplasm Recurrence, Local - surgery</subject><subject>Papillary neoplasm</subject><subject>Retrospective Studies</subject><subject>Sphincterotomy, Endoscopic - methods</subject><subject>Tertiary Care Centers</subject><issn>1590-8658</issn><issn>1878-3562</issn><issn>1878-3562</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE1LxDAURYMozjj6A9xIlm5aX5ombXElg18wIIhu3IQ0eZUM_TLpCPPvzTCjS-FBsjj35eYQcskgZcDkzTq1rU0zyPIU4vDiiMxZWZQJFzI7jndRQVJKUc7IWQhrgIxJAadkxstCQsarOfl4RbPxHnuD1OsJqe4t7XSvP7HDfqK6mdBT7O0QzDA6Q0c9urZFMw3dlrqeahqByWm_pR4b9F631MQk-nNy0ug24MXhXJD3h_u35VOyenl8Xt6tEsNBTIkstOECy4aZJqtNhgWLzURZMTRVaSXnCJGp8xrRgmhqw3ItCmYRWNXkhi_I9X7v6IevDYZJdS4YbFvd47AJKr4iZQEMioiyPWr8EELsq0bvuthdMVA7pWqtolK1U6ogDt9lrg7rN3WH9i_x6zACt3sA4ye_HXoVjNsJtc5HT8oO7p_1P_rjiDI</recordid><startdate>20241201</startdate><enddate>20241201</enddate><creator>Dioscoridi, Lorenzo</creator><creator>Donnarumma, Durante</creator><creator>Forti, Edoardo</creator><creator>Pugliese, Francesco</creator><creator>Cintolo, Marcello</creator><creator>Bonato, Giulia</creator><creator>Bravo, Marianna</creator><creator>Palermo, Andrea</creator><creator>Mutignani, Massimiliano</creator><general>Elsevier Ltd</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/0000-0003-4975-018X</orcidid><orcidid>https://orcid.org/0009-0008-3555-6865</orcidid><orcidid>https://orcid.org/0000-0001-8057-9398</orcidid></search><sort><creationdate>20241201</creationdate><title>Recurrence rate and management after endoscopic papillectomy in a tertiary referral center</title><author>Dioscoridi, Lorenzo ; Donnarumma, Durante ; Forti, Edoardo ; Pugliese, Francesco ; Cintolo, Marcello ; Bonato, Giulia ; Bravo, Marianna ; Palermo, Andrea ; Mutignani, Massimiliano</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c305t-67ac35e8f1cf2bc2e712395891ec98d633e067ab4beed05fbc14a571de019f4c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Adenoma - pathology</topic><topic>Adenoma - surgery</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Ampulla of Vater - pathology</topic><topic>Ampulla of Vater - surgery</topic><topic>Ampulloma</topic><topic>Common Bile Duct Neoplasms - pathology</topic><topic>Common Bile Duct Neoplasms - surgery</topic><topic>Endoscopic papillectomy</topic><topic>ERCP</topic><topic>Female</topic><topic>Humans</topic><topic>Intraductal radiofrequency</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Neoplasm Recurrence, Local - surgery</topic><topic>Papillary neoplasm</topic><topic>Retrospective Studies</topic><topic>Sphincterotomy, Endoscopic - methods</topic><topic>Tertiary Care Centers</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Dioscoridi, Lorenzo</creatorcontrib><creatorcontrib>Donnarumma, Durante</creatorcontrib><creatorcontrib>Forti, Edoardo</creatorcontrib><creatorcontrib>Pugliese, Francesco</creatorcontrib><creatorcontrib>Cintolo, Marcello</creatorcontrib><creatorcontrib>Bonato, Giulia</creatorcontrib><creatorcontrib>Bravo, Marianna</creatorcontrib><creatorcontrib>Palermo, Andrea</creatorcontrib><creatorcontrib>Mutignani, Massimiliano</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>Digestive and liver disease</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Dioscoridi, Lorenzo</au><au>Donnarumma, Durante</au><au>Forti, Edoardo</au><au>Pugliese, Francesco</au><au>Cintolo, Marcello</au><au>Bonato, Giulia</au><au>Bravo, Marianna</au><au>Palermo, Andrea</au><au>Mutignani, Massimiliano</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Recurrence rate and management after endoscopic papillectomy in a tertiary referral center</atitle><jtitle>Digestive and liver disease</jtitle><addtitle>Dig Liver Dis</addtitle><date>2024-12-01</date><risdate>2024</risdate><volume>56</volume><issue>12</issue><spage>2143</spage><epage>2148</epage><pages>2143-2148</pages><issn>1590-8658</issn><issn>1878-3562</issn><eissn>1878-3562</eissn><abstract>Endoscopic papillectomy (EP) is considered a safe procedure for ampullary lesions. Few data are available on management of residual and recurrent adenomas. The aims of the present study were to evaluate long-term recurrence rate, median time-to-recurrence after EP and treatment of both residual and recurrent adenomas.
Consecutive patients who underwent EP of major and minor papilla at our endoscopy center between 2011 and 2022 were enrolled. Residual adenoma was defined as the endoscopic evidence of adenomatous tissue after EP. Recurrent adenoma was defined as the presence of adenomatous tissue after the first endoscopic follow-up and complete adenoma resection.
95 patients satisfied the inclusion criteria. Pathology after resection showed adenoma with low-grade dysplasia (LGD) in 52 patients, high-grade dysplasia (HGD) in 25 patients, adenocarcinoma in 6 patients, NET in 4 patients and not-neoplastic duodenal mucosa in 8 patients. Adverse events occurred in 25 % of patients. The median follow-up after EP was 22.5 months. Local residual was observed in 27 patients (28,4 %) and recurrence after the endoscopic retreatments occurred in 11 patients (11,6 %). Furthermore, recurrence occurred in 16 of 68 patients with adenoma-free after a first endoscopic follow-up and 9 patients developed at least a second recurrence. All the recurrences but one were endoscopically treated.
EP and its ancillary treatments for residual and recurrent adenomas is an effective treatment for ampullary tumors. Long-term surveillance demonstrates that recurrences can be mainly treated endoscopically.</abstract><cop>Netherlands</cop><pub>Elsevier Ltd</pub><pmid>38760239</pmid><doi>10.1016/j.dld.2024.04.037</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0003-4975-018X</orcidid><orcidid>https://orcid.org/0009-0008-3555-6865</orcidid><orcidid>https://orcid.org/0000-0001-8057-9398</orcidid></addata></record> |
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| subjects | Adenoma - pathology Adenoma - surgery Adult Aged Aged, 80 and over Ampulla of Vater - pathology Ampulla of Vater - surgery Ampulloma Common Bile Duct Neoplasms - pathology Common Bile Duct Neoplasms - surgery Endoscopic papillectomy ERCP Female Humans Intraductal radiofrequency Male Middle Aged Neoplasm Recurrence, Local - surgery Papillary neoplasm Retrospective Studies Sphincterotomy, Endoscopic - methods Tertiary Care Centers |
| title | Recurrence rate and management after endoscopic papillectomy in a tertiary referral center |
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