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Comparison of Oncologic Outcomes between Transduodenal Ampullectomy and Pancreatoduodenectomy in Ampulla of Vater Cancer: Korean Multicenter Study
SIMPLE SUMMARY: 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...
Autores principales: | , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8122928/ https://www.ncbi.nlm.nih.gov/pubmed/33922504 http://dx.doi.org/10.3390/cancers13092038 |
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author | 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 |
author_facet | 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 |
author_sort | Hong, Seung-Soo |
collection | PubMed |
description | SIMPLE SUMMARY: 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 2000 to 2019 were collected from 15 institutions. A total of 486 patients were enrolled (PPPD, 418; TDA, 68). The oncologic behavior (tumor size, T stage, differentiation, lymphovascular invasion) in the PPPD group was more aggressive than that in the TDA group at all T stages. The 5-year disease-free survival and overall survival did not differ between the two groups when considering all T stages or only the Tis + T1 group. In T1 patients, PPPD had survival outcomes superior to those in the TDA group. In the TDA group, lymph node dissection did not affect survival. In conclusion, PPPD should be the standard procedure for early AoV cancer. ABSTRACT: 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 (p = 0.034), advanced T stage (p < 0.001), aggressive cell differentiation (p < 0.001), and more lymphovascular invasion (p = 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%, p = 0.040) and superior OS (PPPD vs. TDA, 89.1% vs. 68.0%, p = 0.056) than TDA. Lymph node dissection (LND) in the TDA group did not affect DFS or OS (TDA + LND vs. TDA-only, DFS, p = 0.784; OS, p = 0.870). In conclusion, PPPD should be the standard procedure for early AoV cancer. |
format | Online Article Text |
id | pubmed-8122928 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-81229282021-05-16 Comparison of Oncologic Outcomes between Transduodenal Ampullectomy and Pancreatoduodenectomy in Ampulla of Vater Cancer: Korean Multicenter Study 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 Cancers (Basel) Article SIMPLE SUMMARY: 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 2000 to 2019 were collected from 15 institutions. A total of 486 patients were enrolled (PPPD, 418; TDA, 68). The oncologic behavior (tumor size, T stage, differentiation, lymphovascular invasion) in the PPPD group was more aggressive than that in the TDA group at all T stages. The 5-year disease-free survival and overall survival did not differ between the two groups when considering all T stages or only the Tis + T1 group. In T1 patients, PPPD had survival outcomes superior to those in the TDA group. In the TDA group, lymph node dissection did not affect survival. In conclusion, PPPD should be the standard procedure for early AoV cancer. ABSTRACT: 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 (p = 0.034), advanced T stage (p < 0.001), aggressive cell differentiation (p < 0.001), and more lymphovascular invasion (p = 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%, p = 0.040) and superior OS (PPPD vs. TDA, 89.1% vs. 68.0%, p = 0.056) than TDA. Lymph node dissection (LND) in the TDA group did not affect DFS or OS (TDA + LND vs. TDA-only, DFS, p = 0.784; OS, p = 0.870). In conclusion, PPPD should be the standard procedure for early AoV cancer. MDPI 2021-04-23 /pmc/articles/PMC8122928/ /pubmed/33922504 http://dx.doi.org/10.3390/cancers13092038 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article 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 Comparison of Oncologic Outcomes between Transduodenal Ampullectomy and Pancreatoduodenectomy in Ampulla of Vater Cancer: Korean Multicenter Study |
title | Comparison of Oncologic Outcomes between Transduodenal Ampullectomy and Pancreatoduodenectomy in Ampulla of Vater Cancer: Korean Multicenter Study |
title_full | Comparison of Oncologic Outcomes between Transduodenal Ampullectomy and Pancreatoduodenectomy in Ampulla of Vater Cancer: Korean Multicenter Study |
title_fullStr | Comparison of Oncologic Outcomes between Transduodenal Ampullectomy and Pancreatoduodenectomy in Ampulla of Vater Cancer: Korean Multicenter Study |
title_full_unstemmed | Comparison of Oncologic Outcomes between Transduodenal Ampullectomy and Pancreatoduodenectomy in Ampulla of Vater Cancer: Korean Multicenter Study |
title_short | Comparison of Oncologic Outcomes between Transduodenal Ampullectomy and Pancreatoduodenectomy in Ampulla of Vater Cancer: Korean Multicenter Study |
title_sort | comparison of oncologic outcomes between transduodenal ampullectomy and pancreatoduodenectomy in ampulla of vater cancer: korean multicenter study |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8122928/ https://www.ncbi.nlm.nih.gov/pubmed/33922504 http://dx.doi.org/10.3390/cancers13092038 |
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