Different Periampullary Types and Subtypes Leading to Different Perioperative Outcomes of Pancreatoduodenectomy: Reality and Not a Myth; An International Multicenter Cohort Study.

Fiche publication

Date publication

février 2024

Journal

Cancers

Auteurs

Membres identifiés du Cancéropôle Est :
Pr PESSAUX Patrick

Tous les auteurs :
Uijterwijk BA, Lemmers DH, Fusai GK, Groot Koerkamp B, Koek S, Zerbi A, Sparrelid E, Boggi U, Luyer M, Ielpo B, Salvia R, Goh BKP, Kazemier G, Björnsson B, Serradilla-Martín M, Mazzola M, Mavroeidis VK, Sánchez-Cabús S, Pessaux P, White S, Alseidi A, Valle RD, Korkolis D, Bolm LR, Soonawalla Z, Roberts KJ, Vladimirov M, Mazzotta A, Kleeff J, Suarez Muñoz MA, Besselink MG, Hilal MA,

Lien Pubmed

https://www.ncbi.nlm.nih.gov/pubmed/38473260

Résumé

This international multicenter cohort study included 30 centers. Patients with duodenal adenocarcinoma (DAC), intestinal-type (AmpIT) and pancreatobiliary-type (AmpPB) ampullary adenocarcinoma, distal cholangiocarcinoma (dCCA), and pancreatic ductal adenocarcinoma (PDAC) were included. The primary outcome was 30-day or in-hospital mortality, and secondary outcomes were major morbidity (Clavien-Dindo 3b≥), clinically relevant post-operative pancreatic fistula (CR-POPF), and length of hospital stay (LOS). Results: Overall, 3622 patients were included in the study (370 DAC, 811 AmpIT, 895 AmpPB, 1083 dCCA, and 463 PDAC). Mortality rates were comparable between DAC, AmpIT, AmpPB, and dCCA (ranging from 3.7% to 5.9%), while lower for PDAC (1.5%, = 0.013). Major morbidity rate was the lowest in PDAC (4.4%) and the highest for DAC (19.9%, < 0.001). The highest rates of CR-POPF were observed in DAC (27.3%), AmpIT (25.5%), and dCCA (27.6%), which were significantly higher compared to AmpPB (18.5%, = 0.001) and PDAC (8.3%, < 0.001). The shortest LOS was found in PDAC (11 d vs. 14-15 d, < 0.001). Discussion: In conclusion, this study shows significant variations in perioperative mortality, post-operative complications, and hospital stay among different periampullary cancers, and between the ampullary subtypes. Further research should assess the biological characteristics and tissue reactions associated with each type of periampullary cancer, including subtypes, in order to improve patient management and personalized treatment.