Comparison of Oncologic Outcomes between Transduodenal Ampullectomy and Pancreatoduodenectomy in Ampulla of Vater Cancer: Korean Multicenter Study

This study used multicenter data to compare the oncological safety of transduodenal ampullectomy (TDA) with that of pylorus-preserving pancreatoduodenectomy (PPPD) in early ampulla of Vater (AoV) cancer. Data for patients who underwent surgical resection for AoV cancer (pTis-T2 stage) from January 2...

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Veröffentlicht in:Cancers 2021-04, Vol.13 (9), p.2038
Hauptverfasser: Hong, Seung-Soo, Han, Sung-Sik, Kwon, Wooil, Jang, Jin-Young, Kim, Hee-Joon, Cho, Chol-Kyoon, Ahn, Keun-Soo, Yang, Jae-Do, Park, Youngmok, Min, Seog-Ki, Moon, Ju-Ik, Roh, Young-Hoon, Lee, Seung-Eun, Park, Joon-Seong, Kim, Sang-Geol, Jeong, Chi-Young, Heo, Jin-Seok, Hwang, Ho-Kyoung
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Sprache:eng
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Zusammenfassung:This study used multicenter data to compare the oncological safety of transduodenal ampullectomy (TDA) with that of pylorus-preserving pancreatoduodenectomy (PPPD) in early ampulla of Vater (AoV) cancer. Data for patients who underwent surgical resection for AoV cancer (pTis-T2 stage) from January 2000 to September 2019 were collected from 15 institutions. The clinicopathologic characteristics and survival outcomes were compared between the PPPD and TDA groups. A total of 486 patients were enrolled (PPPD, 418; TDA, 68). The oncologic behavior in the PPPD group was more aggressive than that in the TDA group at all T stages: larger tumor size ( = 0.034), advanced T stage ( < 0.001), aggressive cell differentiation ( < 0.001), and more lymphovascular invasion ( = 0.002). Five-year disease-free survival (DFS) and overall survival (OS) did not differ between the two groups when considering all T stages or only the Tis+T1 group. Among T1 patients, PPPD produced significantly better DFS (PPPD vs. TDA, 84.8% vs. 66.6%, = 0.040) and superior OS (PPPD vs. TDA, 89.1% vs. 68.0%, = 0.056) than TDA. Lymph node dissection (LND) in the TDA group did not affect DFS or OS (TDA + LND vs. TDA-only, DFS, = 0.784; OS, = 0.870). In conclusion, PPPD should be the standard procedure for early AoV cancer.
ISSN:2072-6694
2072-6694
DOI:10.3390/cancers13092038