The Five Periampullary Cancers, not Just Different Siblings but Different Families: An International Multicenter Cohort Study

被引：5

作者：

Uijterwijk, Bas A. ^{[1
,2
]}

Lemmers, Daniel H. ^{[1
,2
]}

Ghidini, Michele ^{[3
]}

Wilmink, Hanneke ^{[4
]}

Zaniboni, Alberto ^{[5
]}

Salvia, Roberto ^{[6
]}

Fusai, Giuseppe Kito ^{[7
]}

Koerkamp, Bas Groot ^{[8
]}

Koek, Sharnice ^{[9
]}

Ghorbani, Poya ^{[10
]}

Zerbi, Alessandro ^{[11
,12
]}

Nappo, Gennaro ^{[11
,12
]}

Luyer, Misha ^{[13
]}

Goh, Brian K. P. ^{[14
]}

Roberts, Keith J. ^{[15
]}

Boggi, Ugo ^{[16
]}

Mavroeidis, Vasileios K. ^{[17
,28
]}

White, Steven ^{[18
]}

Kazemier, Geert ^{[19
]}

Bjornsson, Bergthor ^{[20
]}

Serradilla-Martin, Mario ^{[21
]}

House, Michael G. ^{[22
]}

Alseidi, Adnan ^{[23
]}

Ielpo, Benedetto ^{[24
]}

Mazzola, Michele ^{[25
]}

Jamieson, Nigel ^{[26
]}

Wellner, Ulrich ^{[27
]}

Soonawalla, Zahir ^{[28
]}

Cabus, Santiago Sanchez ^{[29
]}

Dalla Valle, Raffaele ^{[30
]}

Pessaux, Patrick ^{[31
]}

Vladimirov, Miljana ^{[32
]}

Kent, Tara S. ^{[33
]}

Tang, Chung N. ^{[34
]}

Fisher, William E. ^{[35
]}

Kleeff, Jorg ^{[36
]}

Mazzotta, Alessandro ^{[37
]}

Munoz, Miguel Angel Suarez ^{[38
]}

Berger, Adam C. ^{[39
]}

Ball, Chad G. ^{[40
]}

Korkolis, Dimitris ^{[41
]}

Bannone, Elisa ^{[42
]}

Ferarri, Clarissa ^{[42
]}

Besselink, Marc G. ^{[1
,2
]}

Abu Hilal, Mohammed ^{[42
]}

机构：

[1] Univ Amsterdam, Dept Surg, Amsterdam UMC, Amsterdam, Netherlands

[2] Canc Ctr Amsterdam, Amsterdam, Netherlands

[3] Fdn IRCCS CaGranda, Dept Med Oncol, Policlin Milano, Milan, Italy

[4] Univ Amsterdam, Dept Med Oncol, Amsterdam UMC, Amsterdam, Netherlands

[5] Fdn Poliambulanza, Dept Med Oncol, Brescia, Italy

[6] Univ Verona Hosp Trust, Pancreas Inst, Dept Gen & Pancreat Surg, Verona, Italy

[7] Royal Free London NHS Fdn Trust, Dept Surg, London, England

[8] Erasmus MC Canc Inst, Dept Surg, Rotterdam, Netherlands

[9] Fiona Stanley Hosp, Dept Surg, Perth, Australia

[10] Karolinska Inst, Karolinska Univ Hosp, Dept Clin Sci Intervent & Technol, Div Surg, Stockholm, Sweden

[11] Humanitas Univ, Dept Biomed Sci, Pieve Emanuele, Italy

[12] IRCCS Humanitas Res Hosp, Pancreat Surg, Rozzano, Italy

[13] Catharina Hosp, Dept Surg, Eindhoven, Netherlands

[14] Duke Natl Univ Singapore, Singapore Gen Hosp, Dept Hepatopancreatobiliary & Transplant Surg, Singapore, Singapore

[15] Univ Birmingham, Fac Med, Birmingham, England

[16] Pisa Univ Hosp, Dept Surg, Pisa, Italy

[17] Royal Marsden Hosp, Dept Acad Surg, London, England

[18] Newcastle Tyne Hosp NHS Fdn Trust, Dept Surg, Newcastle, England

[19] Vrije Univ Amsterdam Med Ctr, Amsterdam UMC, Dept Surg, Amsterdam, Netherlands

[20] Linkoping Univ Hosp, Dept Surg, Linkoping, Sweden

[21] Miguel Servet Univ Hosp, Dept Surg, Zaragoza, Spain

[22] Indiana Univ Sch Med, Dept Surg, Indianapolis, IN USA

[23] Virginia Mason, Dept Surg, Seattle, WA USA

[24] Hosp Mar, Barcelona, Spain

[25] ASST Grande Osped Metropolitano Niguarda, Div Oncol & Mini Invas Gen Surg, Milan, Italy

[26] Glasgow Royal Infirm, West Scotland Pancreat Unit, Glasgow, Scotland

[27] Univ Med Ctr Schleswig Holstein, Dept Surg, Lubeck, Germany

[28] Oxford Univ Hosp NHS Fdn Trust, Dept Hepatobiliary & Pancreat Surg, Oxford, England

[29] Hosp Sant Pau, Dept Surg, Barcelona, Spain

[30] Univ Hosp Parma, Dept Surg, Parma, Italy

[31] Nouvel Hop Civil NHC, Hepatobiliary & Pancreat Surg Unit, Strasbourg, France

[32] Paracelsus Med Private Univ PMU, Dept Surg, Nuremberg, Austria

[33] Harvard Med Sch, Beth Israel Deaconess Med Ctr, Dept Surg, Boston, MA 02215 USA

[34] Pamela Youde Nethersole Eastern Hosp, Dept Surg, Hong Kong, Peoples R China

[35] Baylor Coll Med, Dept Surg, Houston, TX USA

[36] Martin Luther Univ Halle Wittenberg, Dept Surg, Halle, Saale, Germany

[37] Inst Mutualiste Montsouris, Dept Digest Oncol & Metab Surg, Paris, France

[38] Hosp Univ Virgen Victoria, Malaga, Spain

[39] Jefferson Med Coll, Dept Surg, Philadelphia, PA USA

[40] Univ Calgary, Dept Surg, Calgary, AB, Canada

[41] Hellen Anticanc Hosp St Savvas, Athens, Greece

[42] Inst Fdn Poliambulanza, Dept Hepatobiliary & Pancreat Surg, Brescia, Italy

来源：

ANNALS OF SURGICAL ONCOLOGY | 2024年 / 31卷 / 09期

关键词：

LONG-TERM SURVIVAL; AMPULLARY CANCER; ADENOCARCINOMA; PANCREATICODUODENECTOMY; CARCINOMAS; RESECTION; CA-19-9; CHEMOTHERAPY; PAPILLA; UTILITY;

D O I：

10.1245/s10434-024-15555-8

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Background: Cancer arising in the periampullary region can be anatomically classified in pancreatic ductal adenocarcinoma (PDAC), distal cholangiocarcinoma (dCCA), duodenal adenocarcinoma (DAC), and ampullary carcinoma. Based on histopathology, ampullary carcinoma is currently subdivided in intestinal (AmpIT), pancreatobiliary (AmpPB), and mixed subtypes. Despite close anatomical resemblance, it is unclear how ampullary subtypes relate to the remaining periampullary cancers in tumor characteristics and behavior. Methods: This international cohort study included patients after curative intent resection for periampullary cancer retrieved from 44 centers (from Europe, United States, Asia, Australia, and Canada) between 2010 and 2021. Preoperative CA19-9, pathology outcomes and 8-year overall survival were compared between DAC, AmpIT, AmpPB, dCCA, and PDAC. Results: Overall, 3809 patients were analyzed, including 348 DAC, 774 AmpIT, 848 AmpPB, 1,036 dCCA, and 803 PDAC. The highest 8-year overall survival was found in patients with AmpIT and DAC (49.8% and 47.9%), followed by AmpPB (34.9%, P < 0.001), dCCA (26.4%, P = 0.020), and finally PDAC (12.9%, P < 0.001). A better survival was correlated with lower CA19-9 levels but not with tumor size, as DAC lesions showed the largest size. Conclusions: Despite close anatomic relations of the five periampullary cancers, this study revealed differences in preoperative blood markers, pathology, and long-term survival. More tumor characteristics are shared between DAC and AmpIT and between AmpPB and dCCA than between the two ampullary subtypes. Instead of using collective definitions for "periampullary cancers" or anatomical classification, this study emphasizes the importance of individual evaluation of each histopathological subtype with the ampullary subtypes as individual entities in future studies.

引用

页码：6157 / 6169

页数：13

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