Clinicopathological Stratification and Long-term Follow-up of Patients with Periampullary Carcinomas

Schmuck, Rosa; Brokat, Christian; Ανδρέου, Ανδρέας; Felsenstein, Matthäus; Klein, Fritz; Sinn, Bruno Valentin; Pratschke, Johann; Bahra, Marcus

doi:10.21873/anticanres.12867

Cited by 5 publications

(3 citation statements)

References 26 publications

(37 reference statements)

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“…Our data reinforces the reported favorable prognosis seen in patients with DC as opposed to those with PDAC [ 1 ], likely due to differences in tumor biology [ 19 ] and behavior [ 20 ]. Furthermore, we found that R1 resection affected survival among patients with PDAC but did not reach statistical significance in those with DC.…”

Section: Discussionsupporting

confidence: 89%

Prospective Evaluation of Resection Margins Using Standardized Specimen Protocol Analysis among Patients with Distal Cholangiocarcinoma and Pancreatic Ductal Adenocarcinoma

Garnier

Ewald

Poizat

et al. 2021

JCM

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Purpose: Using a standardized specimen protocol analysis, this study aimed to evaluate the resection margin status of patients who underwent resection for either distal cholangiocarcinoma (DC) or pancreatic ductal adenocarcinoma (PDAC). This allowed a precise millimetric analysis of each inked margin. Methods: From 2010 to 2018, 355 consecutively inked specimens from patients with PDAC (n = 288) or DC (n = 67) were prospectively assessed. We assessed relationships between the tumor and the following margins: transection of the pancreatic neck, bile duct, posterior surface, margin toward superior mesenteric artery, and the surface of superior mesenteric vein/portal vein groove. Resection margins were evaluated using a predefined cut-off value of 1 mm; however, clearances of 0 and 1.5 mm were also evaluated. Results: Patients with DC were mostly men (64% vs. 49%, p = 0.028), of older age (68 yo vs. 65, p = 0.033), required biliary stenting more frequently (93% vs. 77%, p < 0.01), and received less neoadjuvant treatment (p < 0.001) than patients with PDAC. The venous resection rate was higher among patients with PDAC (p = 0.028). Postoperative and 90-day mortality rates were comparable. Patients with PDAC had greater tumor size (28.6 vs. 24 mm, p = 0.01) than those with DC. The R1 resection rate was comparable between the two groups, regardless of the clearance margin. Among the three types of resection margins, a venous groove was the most frequent in both entities. In multivariate analysis, the R1 resection margin did not influence patient survival in either PDAC or DC. Conclusion: Our standardized specimen protocol analysis showed that the R1 resection rate was comparable in PDAC and DC.

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Section: Discussionsupporting

confidence: 89%

Prospective Evaluation of Resection Margins Using Standardized Specimen Protocol Analysis among Patients with Distal Cholangiocarcinoma and Pancreatic Ductal Adenocarcinoma

Garnier

Ewald

Poizat

et al. 2021

JCM

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“…In recent years, the incidence of periampullary tumors has been increasing. According to different histological subtypes, ampullary carcinoma can be divided into intestinal, pancreaticobiliary, and mixed types 1 . If the tumor is larger than 3 cm, with poor differentiation and peripheral nerve invasion, the 5‐year survival rate is only about 24%–42% 2,3 .…”

Section: Introductionmentioning

confidence: 99%

“…According to different histological subtypes, ampullary carcinoma can be divided into intestinal, pancreaticobiliary, and mixed types. 1 If the tumor is larger than 3 cm, with poor differentiation and peripheral nerve invasion, the 5-year survival rate is only about 24%-42%. 2,3 Since the particularity of periampullary anatomical structure and the different subtypes of lesions have different treatments and prognoses, 4 an accurate location and qualitative diagnosis identification are essential for periampullary lesions in the early stage.…”

Section: Introductionmentioning

confidence: 99%

Differential diagnostic value of periampullary mass: A nomogram established by random forest based on clinical characteristics and contrast‐enhanced ultrasound

Zhu

Yang

et al. 2022

J of Clinical Ultrasound

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Purposes: To develop a nomogram model for distinguishing benign from malignant ampullary lesions more intuitive and accurate. Materials and Methods: A total of 124 patients with periampullary lesions from January 2016 to June 2020 were enrolled in this retrospective study. Their clinical information, ultrasound (US), dual contrast-enhanced ultrasound (DCEUS) and MRI image features were used for research. Twenty features were collected in our study. Random forest was used to select the first five most important indicators to construct the prediction model. Results: Patients' age, common bile duct (CBD) diameter, the shape, vascularity, and boundary of lesion, lesion size with or without enlarged after CEUS, the enhancement patterns of arterial phase, the washout patterns of venous phase, CEUS diagnosis, and MRI diagnosis were statistically significant (p < 0.05). After screening for statistically significant indicators by random forest, the first five most important indicators were age,CBD diameter, the enhancement patterns of arterial phase, the washout patterns of venous phase, lesion size with or without enlarged after CEUS, which were used to construct nomogram. The area under curves (AUC) and 95% confidence intervals (CI) for nomogram, MRI + MRCP + DCEUS, DCEUS, MRI + MRCP were 0.98(0.94-1.00), 0.91 (0.84-0.97), 0.89(0.80-0.98), 0.68(0.60-0.77), respectively. The sensitivity and specificity were 100.00% and 84.62% for nomogram, 88.29% and 92.31% for MRI + MRCP+-DCEUS, 86.49% and 92.31% for DCEUS, 51.35%, and 100.00% for MRI + MRCP. Conclusions:We combined clinical indicators, gray-scale ultrasound characteristics, and CEUS characteristics to build the nomogram, which can be intuitively and accurately used for preoperative malignant prediction of ampullary lesion patients, worthy of clinical generalizability and application.

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Long‐term Survival After Resection of Periampullary Cancer

2023

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Clinicopathological Stratification and Long-term Follow-up of Patients with Periampullary Carcinomas

Abstract: Patients suffering from PDAC have the worst prognosis and greatest benefit from radical resection of all patients with periampullary tumors. More detailed studies are warranted to better distinguish between the different entities.

Cited by 5 publications

References 26 publications

Prospective Evaluation of Resection Margins Using Standardized Specimen Protocol Analysis among Patients with Distal Cholangiocarcinoma and Pancreatic Ductal Adenocarcinoma

Prospective Evaluation of Resection Margins Using Standardized Specimen Protocol Analysis among Patients with Distal Cholangiocarcinoma and Pancreatic Ductal Adenocarcinoma

Differential diagnostic value of periampullary mass: A nomogram established by random forest based on clinical characteristics and contrast‐enhanced ultrasound

Long‐term Survival After Resection of Periampullary Cancer

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