Endoscopic and Surgical Management of Non-Metastatic Ampullary Neuroendocrine Neoplasia : A Multi-Institutional Pancreas2000/EPC Study

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Endoscopic and Surgical Management of Non-Metastatic Ampullary Neuroendocrine Neoplasia : A Multi-Institutional Pancreas2000/EPC Study

Karam, Elias (author): University Of Tours

Hollenbach, Marcus (author): Leipzig University

Abou Ali, Einas (author): Cochin Hospital

Auriemma, Francesco (author): Humanitas Research Hospital

Anderloni, Andrea (author): Policlinico San Matteo Pavia Fondazione

Barbier, Louise (author): University Of Tours

Belfiori, Giulio (author): Vita-Salute San Raffaele University

Caillol, Fabrice (author): Institut Paoli-Calmettes

Crippa, Stefano (author): Vita-Salute San Raffaele University

Del Chiaro, Marco (author): University of Colorado School of Medicine

De Ponthaud, Charles (author): Pitié-Salpêtrière University Hospital

Dahel, Yanis (author): Institut Paoli-Calmettes

Falconi, Massimo (author): Vita-Salute San Raffaele University

Giovannini, Marc (author): Institut Paoli-Calmettes

Heling, Dominik (author): University Hospital Bonn

Inoue, Yosuke (author): Cancer Institute Hospital of Japanese Foundation for Cancer Research

Jarnagin, William R. (author): Memorial Sloan-Kettering Cancer Center

Leung, Galen (author): University of Pennsylvania

Lupinacci, Renato M. (author)

Mariani, Alberto (author): Vita-Salute San Raffaele University

Masaryk, Viliam (author)

Miksch, Rainer Christoph (author): Ludwig-Maximilian University of Munich

Musquer, Nicolas (author)

Napoleon, Bertrand (author)

Oba, Atsushi (author): University of Colorado School of Medicine

Partelli, Stefano (author): Vita-Salute San Raffaele University

Petrone, Maria C. (author): Vita-Salute San Raffaele University

Prat, Frédéric (author): Cochin Hospital

Repici, Alessandro (author): Humanitas Research Hospital

Sauvanet, Alain (author): Beaujon Hospital

Salzmann, Katrin (author): University Medical Center Göttingen

Schattner, Mark A. (author): Memorial Sloan-Kettering Cancer Center

Schulick, Richard (author): University of Colorado School of Medicine

Schwarz, Lilian (author): Hopital Charles Nicolle

Soares, Kevin (author): Memorial Sloan-Kettering Cancer Center

Souche, François R. (author): Montpellier University Hospital

Truant, Stéphanie (author): Lille University Hospital

Vaillant, Jean C. (author): Pitié-Salpêtrière University Hospital

Wang, Tiegong (author): Memorial Sloan-Kettering Cancer Center,Cangzhou Central Hospital

Wedi, Edris (author): University Medical Center Göttingen,Sana Hospital Lichtenberg

Werner, Jens (author): Ludwig-Maximilian University of Munich

Weismüller, Tobias J. (author): Pitié-Salpêtrière University Hospital,Vivantes Humboldt Hospital

Wichmann, Dörte (author): University Hospital of Tubingen

Will, Uwe (author): SRH Wald-Klinikum Gera

Zaccari, Piera (author): Vita-Salute San Raffaele University

Gulla, Aiste (author): MedStar Georgetown University Hospital,Vilnius University

Heise, Christian (author): Martin-Luther-Universität Halle-Wittenberg

Regner, Sara (author): Lund University,Lunds universitet,Kirurgi,Forskargrupper vid Lunds universitet,Surgery,Lund University Research Groups

Gaujoux, Sébastien (author): Paris-Sorbonne University,Pitié-Salpêtrière University Hospital

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2023
2023
English 11 s.
In: Neuroendocrinology. - 0028-3835. ; 113:10, s. 1024-1034

Related links:: http://dx.doi.org/10...; show more...; https://lup.lub.lu.s...; https://doi.org/10.1...; show less...

Journal article (peer-reviewed)

Abstract Subject headings

Introduction: Ampullary neuroendocrine neoplasia (NEN) is rare and evidence regarding their management is scarce. This study aimed to describe clinicopathological features, management, and prognosis of ampullary NEN according to their endoscopic or surgical management. Methods: From a multi-institutional international database, patients treated with either endoscopic papillectomy (EP), transduodenal surgical ampullectomy (TSA), or pancreaticoduodenectomy (PD) for ampullary NEN were included. Clinical features, post-procedure complications, and recurrences were assessed. Results: 65 patients were included, 20 (30.8%) treated with EP, 19 (29.2%) with TSA, and 26 (40%) with PD. Patients were mostly asymptomatic (n = 46; 70.8%). Median tumor size was 17 mm (12-22), tumors were mostly grade 1 (70.8%) and pT2 (55.4%). Two (10%) EP resulted in severe American Society for Gastrointestinal Enterology (ASGE) adverse post-procedure complications and 10 (50%) were R0. Clavien 3-5 complications did not occur after TSA and in 4, including 1 postoperative death (15.4%) of patients after PD, with 17 (89.5%) and 26 R0 resection (100%), respectively. The pN1/2 rate was 51.9% (n = 14) after PD. Tumor size larger than 1 cm (i.e., pT stage >1) was a predictor for R1 resection (p < 0.001). Three-year overall survival and disease-free survival after EP, TSA, and PD were 92%, 68%, 92% and 92%, 85%, 73%, respectively. Conclusion: Management of ampullary NEN is challenging. EP should not be performed in lesions larger than 1 cm or with a endoscopic ultrasonography T stage beyond T1. Local resection by TSA seems safe and feasible for lesions without nodal involvement. PD should be preferred for larger ampullary NEN at risk of nodal metastasis.

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By the author/editor: Karam, Elias; Hollenbach, Marc ...; Abou Ali, Einas; Auriemma, France ...; Anderloni, Andre ...; Barbier, Louise; show more...; Belfiori, Giulio; Caillol, Fabrice; Crippa, Stefano; Del Chiaro, Marc ...; De Ponthaud, Cha ...; Dahel, Yanis; Falconi, Massimo; Giovannini, Marc; Heling, Dominik; Inoue, Yosuke; Jarnagin, Willia ...; Leung, Galen; Lupinacci, Renat ...; Mariani, Alberto; Masaryk, Viliam; Miksch, Rainer C ...; Musquer, Nicolas; Napoleon, Bertra ...; Oba, Atsushi; Partelli, Stefan ...; Petrone, Maria C ...; Prat, Frédéric; Repici, Alessand ...; Sauvanet, Alain; Salzmann, Katrin; Schattner, Mark ...; Schulick, Richar ...; Schwarz, Lilian; Soares, Kevin; Souche, François ...; Truant, Stéphani ...; Vaillant, Jean C ...; Wang, Tiegong; Wedi, Edris; Werner, Jens; Weismüller, Tobi ...; Wichmann, Dörte; Will, Uwe; Zaccari, Piera; Gulla, Aiste; Heise, Christian; Regner, Sara; Gaujoux, Sébasti ...; show less...

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Surgery

Articles in the publication: Neuroendocrinolo ...

By the university: Lund University

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Endoscopic and Surgical Management of Non-Metastatic Ampullary Neuroendocrine Neoplasia : A Multi-Institutional Pancreas2000/EPC Study

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