Endoscopic papillectomy for ampullary lesions in patients with familial adenomatous polyposis compared with sporadic lesions: A propensity score-matched cohort

Kien Vu Trung; Einas Abou-Ali; Fabrice Caillol; Woo H. Paik; Bertrand Napoleon; Viliam Masaryk; Sophia E. Van Der Wiel; Enrique Pérez-Cuadrado-Robles; Nicolas Musquer; Asif Halimi; Kevin Soares; Francois R. Souche; Steffen Seyfried; Maria C. Petrone; Stefano Crippa; Tobias Kleemann; David Albers; Tobias J. Weismüller; Ana Dugic; Benjamin Meier; Edris Wedi; Moritz Schiemer; Sara Regner; Sebastien Gaujoux; Marcus Hollenbach; Francesco Auriemma; Aiste Gulla; Elias Karam; Marc Giovannini; Jean Philippe Ratone; Uwe Will; Rita Saadeh; Marco J. Bruno; Pierre Deprez; Urban Arnelo; Erik Haraldsson; Alexander Waldthaler; Galen Leung; Mark A. Schattner; William R. Jarnagin; Tiegong Wang; Jean M. Fabre; Georg Kähler; Alberto Mariani; Piera Zaccari; Giulio Belfiori; Massimo Falconi; Stefano Partelli; Alessandro Repici; Andrea Anderloni; Johanna Laukkarinen; Albrecht Hoffmeister; Jonas Rosendahl; Brigitte Schumacher; Louise Barbier; Dominik Heling; Steffen Muehldorfer; Stéphanie Truant; Karel Caca; Marcel Tantau; Katrin Salzmann; Patrice David; Arthur Schmidt; Tullio Piardi; J. Matthias Löhr; Johan Gagnière; Bogdan P. Miutescu; Arthur Berger; Peter Schemmer; Christian Heise; Vasile Sandru; Reea Ahola; Mario Dinis-Ribeiro; Tiago Cúrdia Gonçalves; Dörte Wichmann

doi:10.1055/a-2029-2935

Endoscopic papillectomy for ampullary lesions in patients with familial adenomatous polyposis compared with sporadic lesions: A propensity score-matched cohort

Kien Vu Trung, Einas Abou-Ali, Fabrice Caillol, Woo H. Paik, Bertrand Napoleon, Viliam Masaryk, Sophia E. Van Der Wiel, Enrique Pérez-Cuadrado-Robles, Nicolas Musquer, Asif Halimi, Kevin Soares, Francois R. Souche, Steffen Seyfried, Maria C. Petrone, Stefano Crippa, Tobias Kleemann, David Albers, Tobias J. Weismüller, Ana Dugic, Benjamin MeierEdris Wedi, Moritz Schiemer, Sara Regner, Sebastien Gaujoux, Marcus Hollenbach^*, Francesco Auriemma, Aiste Gulla, Elias Karam, Marc Giovannini, Jean Philippe Ratone, Uwe Will, Rita Saadeh, Marco J. Bruno, Pierre Deprez, Urban Arnelo, Erik Haraldsson, Alexander Waldthaler, Galen Leung, Mark A. Schattner, William R. Jarnagin, Tiegong Wang, Jean M. Fabre, Georg Kähler, Alberto Mariani, Piera Zaccari, Giulio Belfiori, Massimo Falconi, Stefano Partelli, Alessandro Repici, Andrea Anderloni, Johanna Laukkarinen, Albrecht Hoffmeister, Jonas Rosendahl, Brigitte Schumacher, Louise Barbier, Dominik Heling, Steffen Muehldorfer, Stéphanie Truant, Karel Caca, Marcel Tantau, Katrin Salzmann, Patrice David, Arthur Schmidt, Tullio Piardi, J. Matthias Löhr, Johan Gagnière, Bogdan P. Miutescu, Arthur Berger, Peter Schemmer, Christian Heise, Vasile Sandru, Reea Ahola, Mario Dinis-Ribeiro, Tiago Cúrdia Gonçalves, Dörte Wichmann

^*Corresponding author for this work

Gastroenterology & Hepatology

Research output: Contribution to journal › Article › Academic › peer-review

8 Citations (Scopus)

Abstract

Background Familial adenomatous polyposis (FAP) is a rare inherited syndrome that predisposes the patient to cancer. Treatment of FAP-related ampullary lesions is challenging and the role of endoscopic papillectomy has not been elucidated. We retrospectively analyzed the outcomes of endoscopic papillectomy in matched cohorts of FAPrelated and sporadic ampullary lesions (SALs). Methods This retrospective multicenter study included 1422 endoscopic papillectomy procedures. Propensity score matching including age, sex, comorbidity, histologic subtype, and size was performed. Main outcomes were complete resection (R0), technical success, complications, and recurrence. Results Propensity score matching identified 202 patients (101 FAP, 101 SAL) with comparable baseline characteristics. FAP patients were mainly asymptomatic (79.2% [95 %CI 71.2-87.3] vs. 46.5% [95 %CI 36.6-56.4]); P < 0.001). The initial R0 rate was significantly lower in FAP patients (63.4% [95%CI 53.8-72.9] vs. 83.2% [95%CI 75.8-90.6]; P = 0.001). After repeated interventions (mean 1.30 per patient), R0 was comparable (FAP 93.1% [95%CI 88.0-98.1] vs. SAL 97.0% [95%CI 93.7-100]; P = 0.19). Adverse events occurred in 28.7%. Pancreatitis and bleeding were the most common adverse events in both groups. Severe adverse events were rare (3.5 %). Overall, 21 FAP patients (20.8% [95%CI 12.7-28.8]) and 16 SAL patients (15.8% [95%CI 8.6-23.1]; P = 0.36) had recurrence. Recurrences occurred later in FAP patients (25 [95 %CI 18.3-31.7] vs. 2 [95 %CI CI 0.06-3.9] months). Conclusions Endoscopic papillectomy was safe and effective in FAP-related ampullary lesions. Criteria for endoscopic resection of ampullary lesions can be extended to FAP patients. FAP patients have a lifetime risk of relapse even after complete resection, and require long-time surveillance.

Original language	English
Pages (from-to)	709-718
Number of pages	10
Journal	Endoscopy
Volume	55
Issue number	8
DOIs	https://doi.org/10.1055/a-2029-2935
Publication status	Published - 19 May 2022

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© 2022 Georg Thieme Verlag. All rights reserved.

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10.1055/a-2029-2935

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Vu Trung, K., Abou-Ali, E., Caillol, F., Paik, W. H., Napoleon, B., Masaryk, V., Van Der Wiel, S. E., Pérez-Cuadrado-Robles, E., Musquer, N., Halimi, A., Soares, K., Souche, F. R., Seyfried, S., Petrone, M. C., Crippa, S., Kleemann, T., Albers, D., Weismüller, T. J., Dugic, A., ... Wichmann, D. (2022). Endoscopic papillectomy for ampullary lesions in patients with familial adenomatous polyposis compared with sporadic lesions: A propensity score-matched cohort. Endoscopy, 55(8), 709-718. https://doi.org/10.1055/a-2029-2935

@article{07e0b0865be0465fb53ef6dad4d790b0,

title = "Endoscopic papillectomy for ampullary lesions in patients with familial adenomatous polyposis compared with sporadic lesions: A propensity score-matched cohort",

abstract = "Background Familial adenomatous polyposis (FAP) is a rare inherited syndrome that predisposes the patient to cancer. Treatment of FAP-related ampullary lesions is challenging and the role of endoscopic papillectomy has not been elucidated. We retrospectively analyzed the outcomes of endoscopic papillectomy in matched cohorts of FAPrelated and sporadic ampullary lesions (SALs). Methods This retrospective multicenter study included 1422 endoscopic papillectomy procedures. Propensity score matching including age, sex, comorbidity, histologic subtype, and size was performed. Main outcomes were complete resection (R0), technical success, complications, and recurrence. Results Propensity score matching identified 202 patients (101 FAP, 101 SAL) with comparable baseline characteristics. FAP patients were mainly asymptomatic (79.2% [95 %CI 71.2-87.3] vs. 46.5% [95 %CI 36.6-56.4]); P < 0.001). The initial R0 rate was significantly lower in FAP patients (63.4% [95%CI 53.8-72.9] vs. 83.2% [95%CI 75.8-90.6]; P = 0.001). After repeated interventions (mean 1.30 per patient), R0 was comparable (FAP 93.1% [95%CI 88.0-98.1] vs. SAL 97.0% [95%CI 93.7-100]; P = 0.19). Adverse events occurred in 28.7%. Pancreatitis and bleeding were the most common adverse events in both groups. Severe adverse events were rare (3.5 %). Overall, 21 FAP patients (20.8% [95%CI 12.7-28.8]) and 16 SAL patients (15.8% [95%CI 8.6-23.1]; P = 0.36) had recurrence. Recurrences occurred later in FAP patients (25 [95 %CI 18.3-31.7] vs. 2 [95 %CI CI 0.06-3.9] months). Conclusions Endoscopic papillectomy was safe and effective in FAP-related ampullary lesions. Criteria for endoscopic resection of ampullary lesions can be extended to FAP patients. FAP patients have a lifetime risk of relapse even after complete resection, and require long-time surveillance.",

author = "{Vu Trung}, Kien and Einas Abou-Ali and Fabrice Caillol and Paik, {Woo H.} and Bertrand Napoleon and Viliam Masaryk and {Van Der Wiel}, {Sophia E.} and Enrique P{\'e}rez-Cuadrado-Robles and Nicolas Musquer and Asif Halimi and Kevin Soares and Souche, {Francois R.} and Steffen Seyfried and Petrone, {Maria C.} and Stefano Crippa and Tobias Kleemann and David Albers and Weism{\"u}ller, {Tobias J.} and Ana Dugic and Benjamin Meier and Edris Wedi and Moritz Schiemer and Sara Regner and Sebastien Gaujoux and Marcus Hollenbach and Francesco Auriemma and Aiste Gulla and Elias Karam and Marc Giovannini and Ratone, {Jean Philippe} and Uwe Will and Rita Saadeh and Bruno, {Marco J.} and Pierre Deprez and Urban Arnelo and Erik Haraldsson and Alexander Waldthaler and Galen Leung and Schattner, {Mark A.} and Jarnagin, {William R.} and Tiegong Wang and Fabre, {Jean M.} and Georg K{\"a}hler and Alberto Mariani and Piera Zaccari and Giulio Belfiori and Massimo Falconi and Stefano Partelli and Alessandro Repici and Andrea Anderloni and Johanna Laukkarinen and Albrecht Hoffmeister and Jonas Rosendahl and Brigitte Schumacher and Louise Barbier and Dominik Heling and Steffen Muehldorfer and St{\'e}phanie Truant and Karel Caca and Marcel Tantau and Katrin Salzmann and Patrice David and Arthur Schmidt and Tullio Piardi and L{\"o}hr, {J. Matthias} and Johan Gagni{\`e}re and Miutescu, {Bogdan P.} and Arthur Berger and Peter Schemmer and Christian Heise and Vasile Sandru and Reea Ahola and Mario Dinis-Ribeiro and Gon{\c c}alves, {Tiago C{\'u}rdia} and D{\"o}rte Wichmann",

year = "2022",

month = may,

day = "19",

doi = "10.1055/a-2029-2935",

language = "English",

volume = "55",

pages = "709--718",

journal = "Endoscopy",

issn = "0013-726X",

publisher = "Georg Thieme Verlag",

number = "8",

}

Vu Trung, K, Abou-Ali, E, Caillol, F, Paik, WH, Napoleon, B, Masaryk, V, Van Der Wiel, SE, Pérez-Cuadrado-Robles, E, Musquer, N, Halimi, A, Soares, K, Souche, FR, Seyfried, S, Petrone, MC, Crippa, S, Kleemann, T, Albers, D, Weismüller, TJ, Dugic, A, Meier, B, Wedi, E, Schiemer, M, Regner, S, Gaujoux, S, Hollenbach, M, Auriemma, F, Gulla, A, Karam, E, Giovannini, M, Ratone, JP, Will, U, Saadeh, R, Bruno, MJ, Deprez, P, Arnelo, U, Haraldsson, E, Waldthaler, A, Leung, G, Schattner, MA, Jarnagin, WR, Wang, T, Fabre, JM, Kähler, G, Mariani, A, Zaccari, P, Belfiori, G, Falconi, M, Partelli, S, Repici, A, Anderloni, A, Laukkarinen, J, Hoffmeister, A, Rosendahl, J, Schumacher, B, Barbier, L, Heling, D, Muehldorfer, S, Truant, S, Caca, K, Tantau, M, Salzmann, K, David, P, Schmidt, A, Piardi, T, Löhr, JM, Gagnière, J, Miutescu, BP, Berger, A, Schemmer, P, Heise, C, Sandru, V, Ahola, R, Dinis-Ribeiro, M, Gonçalves, TC & Wichmann, D 2022, 'Endoscopic papillectomy for ampullary lesions in patients with familial adenomatous polyposis compared with sporadic lesions: A propensity score-matched cohort', Endoscopy, vol. 55, no. 8, pp. 709-718. https://doi.org/10.1055/a-2029-2935

TY - JOUR

T1 - Endoscopic papillectomy for ampullary lesions in patients with familial adenomatous polyposis compared with sporadic lesions

T2 - A propensity score-matched cohort

AU - Vu Trung, Kien

AU - Abou-Ali, Einas

AU - Caillol, Fabrice

AU - Paik, Woo H.

AU - Napoleon, Bertrand

AU - Masaryk, Viliam

AU - Van Der Wiel, Sophia E.

AU - Pérez-Cuadrado-Robles, Enrique

AU - Musquer, Nicolas

AU - Halimi, Asif

AU - Soares, Kevin

AU - Souche, Francois R.

AU - Seyfried, Steffen

AU - Petrone, Maria C.

AU - Crippa, Stefano

AU - Kleemann, Tobias

AU - Albers, David

AU - Weismüller, Tobias J.

AU - Dugic, Ana

AU - Meier, Benjamin

AU - Wedi, Edris

AU - Schiemer, Moritz

AU - Regner, Sara

AU - Gaujoux, Sebastien

AU - Hollenbach, Marcus

AU - Auriemma, Francesco

AU - Gulla, Aiste

AU - Karam, Elias

AU - Giovannini, Marc

AU - Ratone, Jean Philippe

AU - Will, Uwe

AU - Saadeh, Rita

AU - Bruno, Marco J.

AU - Deprez, Pierre

AU - Arnelo, Urban

AU - Haraldsson, Erik

AU - Waldthaler, Alexander

AU - Leung, Galen

AU - Schattner, Mark A.

AU - Jarnagin, William R.

AU - Wang, Tiegong

AU - Fabre, Jean M.

AU - Kähler, Georg

AU - Mariani, Alberto

AU - Zaccari, Piera

AU - Belfiori, Giulio

AU - Falconi, Massimo

AU - Partelli, Stefano

AU - Repici, Alessandro

AU - Anderloni, Andrea

AU - Laukkarinen, Johanna

AU - Hoffmeister, Albrecht

AU - Rosendahl, Jonas

AU - Schumacher, Brigitte

AU - Barbier, Louise

AU - Heling, Dominik

AU - Muehldorfer, Steffen

AU - Truant, Stéphanie

AU - Caca, Karel

AU - Tantau, Marcel

AU - Salzmann, Katrin

AU - David, Patrice

AU - Schmidt, Arthur

AU - Piardi, Tullio

AU - Löhr, J. Matthias

AU - Gagnière, Johan

AU - Miutescu, Bogdan P.

AU - Berger, Arthur

AU - Schemmer, Peter

AU - Heise, Christian

AU - Sandru, Vasile

AU - Ahola, Reea

AU - Dinis-Ribeiro, Mario

AU - Gonçalves, Tiago Cúrdia

AU - Wichmann, Dörte

PY - 2022/5/19

Y1 - 2022/5/19

N2 - Background Familial adenomatous polyposis (FAP) is a rare inherited syndrome that predisposes the patient to cancer. Treatment of FAP-related ampullary lesions is challenging and the role of endoscopic papillectomy has not been elucidated. We retrospectively analyzed the outcomes of endoscopic papillectomy in matched cohorts of FAPrelated and sporadic ampullary lesions (SALs). Methods This retrospective multicenter study included 1422 endoscopic papillectomy procedures. Propensity score matching including age, sex, comorbidity, histologic subtype, and size was performed. Main outcomes were complete resection (R0), technical success, complications, and recurrence. Results Propensity score matching identified 202 patients (101 FAP, 101 SAL) with comparable baseline characteristics. FAP patients were mainly asymptomatic (79.2% [95 %CI 71.2-87.3] vs. 46.5% [95 %CI 36.6-56.4]); P < 0.001). The initial R0 rate was significantly lower in FAP patients (63.4% [95%CI 53.8-72.9] vs. 83.2% [95%CI 75.8-90.6]; P = 0.001). After repeated interventions (mean 1.30 per patient), R0 was comparable (FAP 93.1% [95%CI 88.0-98.1] vs. SAL 97.0% [95%CI 93.7-100]; P = 0.19). Adverse events occurred in 28.7%. Pancreatitis and bleeding were the most common adverse events in both groups. Severe adverse events were rare (3.5 %). Overall, 21 FAP patients (20.8% [95%CI 12.7-28.8]) and 16 SAL patients (15.8% [95%CI 8.6-23.1]; P = 0.36) had recurrence. Recurrences occurred later in FAP patients (25 [95 %CI 18.3-31.7] vs. 2 [95 %CI CI 0.06-3.9] months). Conclusions Endoscopic papillectomy was safe and effective in FAP-related ampullary lesions. Criteria for endoscopic resection of ampullary lesions can be extended to FAP patients. FAP patients have a lifetime risk of relapse even after complete resection, and require long-time surveillance.

AB - Background Familial adenomatous polyposis (FAP) is a rare inherited syndrome that predisposes the patient to cancer. Treatment of FAP-related ampullary lesions is challenging and the role of endoscopic papillectomy has not been elucidated. We retrospectively analyzed the outcomes of endoscopic papillectomy in matched cohorts of FAPrelated and sporadic ampullary lesions (SALs). Methods This retrospective multicenter study included 1422 endoscopic papillectomy procedures. Propensity score matching including age, sex, comorbidity, histologic subtype, and size was performed. Main outcomes were complete resection (R0), technical success, complications, and recurrence. Results Propensity score matching identified 202 patients (101 FAP, 101 SAL) with comparable baseline characteristics. FAP patients were mainly asymptomatic (79.2% [95 %CI 71.2-87.3] vs. 46.5% [95 %CI 36.6-56.4]); P < 0.001). The initial R0 rate was significantly lower in FAP patients (63.4% [95%CI 53.8-72.9] vs. 83.2% [95%CI 75.8-90.6]; P = 0.001). After repeated interventions (mean 1.30 per patient), R0 was comparable (FAP 93.1% [95%CI 88.0-98.1] vs. SAL 97.0% [95%CI 93.7-100]; P = 0.19). Adverse events occurred in 28.7%. Pancreatitis and bleeding were the most common adverse events in both groups. Severe adverse events were rare (3.5 %). Overall, 21 FAP patients (20.8% [95%CI 12.7-28.8]) and 16 SAL patients (15.8% [95%CI 8.6-23.1]; P = 0.36) had recurrence. Recurrences occurred later in FAP patients (25 [95 %CI 18.3-31.7] vs. 2 [95 %CI CI 0.06-3.9] months). Conclusions Endoscopic papillectomy was safe and effective in FAP-related ampullary lesions. Criteria for endoscopic resection of ampullary lesions can be extended to FAP patients. FAP patients have a lifetime risk of relapse even after complete resection, and require long-time surveillance.

UR - http://www.scopus.com/inward/record.url?scp=85166364173&partnerID=8YFLogxK

U2 - 10.1055/a-2029-2935

DO - 10.1055/a-2029-2935

M3 - Article

C2 - 36746390

AN - SCOPUS:85166364173

SN - 0013-726X

VL - 55

SP - 709

EP - 718

JO - Endoscopy

JF - Endoscopy

IS - 8

ER -

Endoscopic papillectomy for ampullary lesions in patients with familial adenomatous polyposis compared with sporadic lesions: A propensity score-matched cohort

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