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Impact of extra-ampullary duodenal adenocarcinoma subtypes on surgical and oncological outcomes following pancreaticoduodenectomy.
- Source :
-
Updates in surgery [Updates Surg] 2024 Jan; Vol. 76 (1), pp. 87-95. Date of Electronic Publication: 2023 Dec 13. - Publication Year :
- 2024
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Abstract
- Background: There is little information about the relevance of extra-ampullary duodenal adenocarcinoma (EDA) subtypes. The aim of this study was to evaluate the impact of EDA subtypes on surgical and oncological outcomes following pancreatoduodenectomy (PD).<br />Methods: Consecutive patients undergoing PD for EDA from 2000 to 2019 were analyzed. Results were stratified by pathologic subtype (intestinal versus non-intestinal). Uni-and multivariable analyses were performed using standard statistical methods.<br />Results: The study population consisted of 70 patients, of whom 49 (70%) had an intestinal phenotype. EDA with intestinal phenotype was more frequently proximal to the Ampulla of Vater, while non-intestinal EDA was more frequently found distally (76% vs. 33%, p = 0.002). Patients with intestinal EDA were less likely to experience severe morbidity, with decreased reoperation and unplanned Intensive Care Unit admission rates relative to non-intestinal subtypes (2% vs. 29% p = 0.002, and 2% vs. 19%, p = 0.007, respectively). The median follow-up post-pancreatectomy was 73 months. Intestinal EDA was associated with improved overall and disease-free survival, with 3-year and 5-year survival rates of 71% vs. 29% and 53% vs. 24%, respectively. (p = 0.019 and p = 0.025).<br />Conclusion: Intestinal-type EDA, which more often arises from supra-ampullary duodenum, was associated with better postoperative outcomes and improved survival.<br /> (© 2023. Italian Society of Surgery (SIC).)
Details
- Language :
- English
- ISSN :
- 2038-3312
- Volume :
- 76
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Updates in surgery
- Publication Type :
- Academic Journal
- Accession number :
- 38093152
- Full Text :
- https://doi.org/10.1007/s13304-023-01688-0