TY - JOUR
T1 - The Five Periampullary Cancers, not Just Different Siblings but Different Families
T2 - An International Multicenter Cohort Study
AU - Uijterwijk, Bas A.
AU - Lemmers, Daniël H.
AU - Ghidini, Michele
AU - for the ISGACA Consortium
AU - Wilmink, Hanneke
AU - Zaniboni, Alberto
AU - Salvia, Roberto
AU - Kito Fusai, Giuseppe
AU - Groot Koerkamp, Bas
AU - Koek, Sharnice
AU - Ghorbani, Poya
AU - Zerbi, Alessandro
AU - Nappo, Gennaro
AU - Luyer, Misha
AU - Goh, Brian K.P.
AU - Roberts, Keith J.
AU - Boggi, Ugo
AU - Mavroeidis, Vasileios K.
AU - White, Steven
AU - Kazemier, Geert
AU - Björnsson, Bergthor
AU - Serradilla-Martín, Mario
AU - House, Michael G.
AU - Alseidi, Adnan
AU - Ielpo, Benedetto
AU - Mazzola, Michele
AU - Jamieson, Nigel
AU - Wellner, Ulrich
AU - Soonawalla, Zahir
AU - Cabús, Santiago Sánchez
AU - Dalla Valle, Raffaele
AU - Pessaux, Patrick
AU - Vladimirov, Miljana
AU - Kent, Tara S.
AU - Tang, Chung N.
AU - Fisher, William E.
AU - Kleeff, Jorg
AU - Mazzotta, Alessandro
AU - Suarez Muñoz, Miguel Angel
AU - Berger, Adam C.
AU - Ball, Chad G.
AU - Korkolis, Dimitris
AU - Bannone, Elisa
AU - Ferarri, Clarissa
AU - Besselink, Marc G.
AU - Abu Hilal, Mohammed
AU - Malleo, Giuseppe
AU - Lancelotti, Francesco
AU - Sparrelid, Ernesto
AU - van Dam, Coen
AU - Ramaekers, Mark
N1 - Publisher Copyright: © Society of Surgical Oncology 2024.
PY - 2024/9
Y1 - 2024/9
N2 - Background: Cancer arising in the periampullary region can be anatomically classified in pancreatic ductal adenocarcinoma (PDAC), distal cholangiocarcinoma (dCCA), duodenal adenocarcinoma (DAC), and ampullary carcinoma. Based on histopathology, ampullary carcinoma is currently subdivided in intestinal (AmpIT), pancreatobiliary (AmpPB), and mixed subtypes. Despite close anatomical resemblance, it is unclear how ampullary subtypes relate to the remaining periampullary cancers in tumor characteristics and behavior. Methods: This international cohort study included patients after curative intent resection for periampullary cancer retrieved from 44 centers (from Europe, United States, Asia, Australia, and Canada) between 2010 and 2021. Preoperative CA19-9, pathology outcomes and 8-year overall survival were compared between DAC, AmpIT, AmpPB, dCCA, and PDAC. Results: Overall, 3809 patients were analyzed, including 348 DAC, 774 AmpIT, 848 AmpPB, 1,036 dCCA, and 803 PDAC. The highest 8-year overall survival was found in patients with AmpIT and DAC (49.8% and 47.9%), followed by AmpPB (34.9%, P < 0.001), dCCA (26.4%, P = 0.020), and finally PDAC (12.9%, P < 0.001). A better survival was correlated with lower CA19-9 levels but not with tumor size, as DAC lesions showed the largest size. Conclusions: Despite close anatomic relations of the five periampullary cancers, this study revealed differences in preoperative blood markers, pathology, and long-term survival. More tumor characteristics are shared between DAC and AmpIT and between AmpPB and dCCA than between the two ampullary subtypes. Instead of using collective definitions for “periampullary cancers” or anatomical classification, this study emphasizes the importance of individual evaluation of each histopathological subtype with the ampullary subtypes as individual entities in future studies.
AB - Background: Cancer arising in the periampullary region can be anatomically classified in pancreatic ductal adenocarcinoma (PDAC), distal cholangiocarcinoma (dCCA), duodenal adenocarcinoma (DAC), and ampullary carcinoma. Based on histopathology, ampullary carcinoma is currently subdivided in intestinal (AmpIT), pancreatobiliary (AmpPB), and mixed subtypes. Despite close anatomical resemblance, it is unclear how ampullary subtypes relate to the remaining periampullary cancers in tumor characteristics and behavior. Methods: This international cohort study included patients after curative intent resection for periampullary cancer retrieved from 44 centers (from Europe, United States, Asia, Australia, and Canada) between 2010 and 2021. Preoperative CA19-9, pathology outcomes and 8-year overall survival were compared between DAC, AmpIT, AmpPB, dCCA, and PDAC. Results: Overall, 3809 patients were analyzed, including 348 DAC, 774 AmpIT, 848 AmpPB, 1,036 dCCA, and 803 PDAC. The highest 8-year overall survival was found in patients with AmpIT and DAC (49.8% and 47.9%), followed by AmpPB (34.9%, P < 0.001), dCCA (26.4%, P = 0.020), and finally PDAC (12.9%, P < 0.001). A better survival was correlated with lower CA19-9 levels but not with tumor size, as DAC lesions showed the largest size. Conclusions: Despite close anatomic relations of the five periampullary cancers, this study revealed differences in preoperative blood markers, pathology, and long-term survival. More tumor characteristics are shared between DAC and AmpIT and between AmpPB and dCCA than between the two ampullary subtypes. Instead of using collective definitions for “periampullary cancers” or anatomical classification, this study emphasizes the importance of individual evaluation of each histopathological subtype with the ampullary subtypes as individual entities in future studies.
UR - http://www.scopus.com/inward/record.url?scp=85196405364&partnerID=8YFLogxK
U2 - 10.1245/s10434-024-15555-8
DO - 10.1245/s10434-024-15555-8
M3 - Article
C2 - 38888860
AN - SCOPUS:85196405364
SN - 1068-9265
VL - 31
SP - 6157
EP - 6169
JO - Annals of Surgical Oncology
JF - Annals of Surgical Oncology
IS - 9
ER -
