Outcome of Minimally Invasive and Open Pancreatoduodenectomy in Patients With Intestinal and Pancreatobiliary Subtype Ampullary Cancer
Year: 2024
Type: article
Study design: Observational Study
Abstract: OBJECTIVE: To compare minimally invasive (MIPD) and open (OPD) pancreatoduodenectomy in different subtypes of ampullary adenocarcinoma (AAC). BACKGROUND: AAC is widely seen as the best indication for MIPD due to the lack of vascular involvement and dilated bile and pancreatic duct. However, it is unknown whether outcomes of MIPD for AAC differ between the pancreatobiliary (AAC-PB) and intestinal (AAC-IT) subtypes as large studies are lacking. METHODS: This is an international cohort study, encompassing 27 centers from 12 countries. Outcomes of MIPD and OPD were compared in patients with AAC-IT and AAC-PB. Primary endpoints were R1 rate, lymph node yield, and 5-year overall survival. RESULTS: Overall, 1187 patients after MIPD for AAC were included, of whom 572 with AAC-IT (62 MIPD and 510 OPD) and 615 with AAC-PB (41 MIPD and 574 OPD). The rate of R1 resection was not significantly different between MIPD and OPD for both AAC-IT (3.4% vs 6.9%, P = 0.425) and AAC-PB (9.8% vs 14.9%, P = 0.625). AAC-IT, more lymph nodes were resected with the MIPD group (19 vs 16, P = 0.007), compared with OPD. The 5-year overall survival did not differ after MIPD and OPD for both AAC-IT (56.8% vs 59.5%, P = 0.827 and AAC-PB (52.5% vs 44.4%, P = 0.357). The rates of surgical complications between MIPD and OPD did not differ between AAC-IT and AAC-PB. CONCLUSIONS: This international multicenter study found no differences in outcomes between MIPD and OPD for AAC-IT and AAC-PB. MIPD and OPD demonstrated comparable outcomes in oncological resection, survival and surgical outcomes for both subtypes of AAC.
Source: Annals of Surgery
Authors: Bas A. Uijterwijk, Alma Moekotte, Ugo Boggi, Michele Mazzola, Bas Groot Koerkamp, Raffaele Dalla Valle, Alessandro Mazzotta, Misha Luyer, Geert Kazemier, Benedetto Ielpo, Miguel Angel Suarez Muñoz, Louisa Bolm, Bergthor Björnsson, Patrick Pessaux, Jorg Kleeff, Giuseppe Kito Fusai, Ernesto Sparrelid, Alessandro Zerbi, Daniël H. Lemmers, Adnan Alseidi, Miljana Vladimirov, Keith J. Roberts, Roberto Salvia, Zahir Soonawalla, Dimitris Korkolis, Mario Serradilla-Martín, Vasileios K. Mavroeidis, Stefan A.W. Bouwense, Marc G. Besselink, Mohammed Abu Hilal, for the International Study Group on non-pancreatic periAmpullary CAncer (ISGACA)
Institutions: Amsterdam UMC Location University of Amsterdam, Fondazione Poliambulanza Istituto Ospedaliero, Amsterdam University Medical Centers, Cancer Center Amsterdam, University of Amsterdam, University of Pisa, Azienda Ospedaliera Universitaria Pisana, Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Virginia Mason Medical Center, Erasmus MC Cancer Institute, University of Parma, Institute Mutualiste Montsouris, Catharina Ziekenhuis, Italian Association for Cancer Research, Amsterdam UMC Location Vrije Universiteit Amsterdam, Hospital Del Mar, Hospital Clínico Universitario Virgen de la Victoria, University Hospital Schleswig-Holstein, University of Lübeck, Linköping University, Hôpital Civil, Strasbourg, Martin Luther University Halle-Wittenberg, Royal Free London NHS Foundation Trust, Karolinska University Hospital, Karolinska Institutet, Humanitas University, IRCCS Humanitas Research Hospital, Paracelsus Medizinische Privatuniversität, Bielefeld University, Klinikum Lippe, University of Birmingham, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, University of Oxford, Oxford University Hospitals NHS Trust, St Savas Hospital, Hospital Universitario Miguel Servet, Instituto de Investigación Sanitaria Aragón, Royal Marsden Hospital, Maastricht University Medical Centre, University Hospital Southampton NHS Foundation Trust
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W4402145647