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  • Karam, EliasUniversity Of Tours (author)

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

  • Article/chapterEnglish2023

Publisher, publication year, extent ...

  • 2023
  • 11 s.

Numbers

  • LIBRIS-ID:oai:lup.lub.lu.se:8140f9ee-fe24-46ea-96bb-185e854aef54
  • https://lup.lub.lu.se/record/8140f9ee-fe24-46ea-96bb-185e854aef54URI
  • https://doi.org/10.1159/000531712DOI

Supplementary language notes

  • Language:English
  • Summary in:English

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  • Subject category:art swepub-publicationtype
  • Subject category:ref swepub-contenttype

Notes

  • 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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  • Hollenbach, MarcusLeipzig University (author)
  • Abou Ali, EinasCochin Hospital (author)
  • Auriemma, FrancescoHumanitas Research Hospital (author)
  • Anderloni, AndreaPoliclinico San Matteo Pavia Fondazione (author)
  • Barbier, LouiseUniversity Of Tours (author)
  • Belfiori, GiulioVita-Salute San Raffaele University (author)
  • Caillol, FabriceInstitut Paoli-Calmettes (author)
  • Crippa, StefanoVita-Salute San Raffaele University (author)
  • Del Chiaro, MarcoUniversity of Colorado School of Medicine (author)
  • De Ponthaud, CharlesPitié-Salpêtrière University Hospital (author)
  • Dahel, YanisInstitut Paoli-Calmettes (author)
  • Falconi, MassimoVita-Salute San Raffaele University (author)
  • Giovannini, MarcInstitut Paoli-Calmettes (author)
  • Heling, DominikUniversity Hospital Bonn (author)
  • Inoue, YosukeCancer Institute Hospital of Japanese Foundation for Cancer Research (author)
  • Jarnagin, William R.Memorial Sloan-Kettering Cancer Center (author)
  • Leung, GalenUniversity of Pennsylvania (author)
  • Lupinacci, Renato M. (author)
  • Mariani, AlbertoVita-Salute San Raffaele University (author)
  • Masaryk, Viliam (author)
  • Miksch, Rainer ChristophLudwig-Maximilian University of Munich (author)
  • Musquer, Nicolas (author)
  • Napoleon, Bertrand (author)
  • Oba, AtsushiUniversity of Colorado School of Medicine (author)
  • Partelli, StefanoVita-Salute San Raffaele University (author)
  • Petrone, Maria C.Vita-Salute San Raffaele University (author)
  • Prat, FrédéricCochin Hospital (author)
  • Repici, AlessandroHumanitas Research Hospital (author)
  • Sauvanet, AlainBeaujon Hospital (author)
  • Salzmann, KatrinUniversity Medical Center Göttingen (author)
  • Schattner, Mark A.Memorial Sloan-Kettering Cancer Center (author)
  • Schulick, RichardUniversity of Colorado School of Medicine (author)
  • Schwarz, LilianHopital Charles Nicolle (author)
  • Soares, KevinMemorial Sloan-Kettering Cancer Center (author)
  • Souche, François R.Montpellier University Hospital (author)
  • Truant, StéphanieLille University Hospital (author)
  • Vaillant, Jean C.Pitié-Salpêtrière University Hospital (author)
  • Wang, TiegongMemorial Sloan-Kettering Cancer Center,Cangzhou Central Hospital (author)
  • Wedi, EdrisUniversity Medical Center Göttingen,Sana Hospital Lichtenberg (author)
  • Werner, JensLudwig-Maximilian University of Munich (author)
  • Weismüller, Tobias J.Pitié-Salpêtrière University Hospital,Vivantes Humboldt Hospital (author)
  • Wichmann, DörteUniversity Hospital of Tubingen (author)
  • Will, UweSRH Wald-Klinikum Gera (author)
  • Zaccari, PieraVita-Salute San Raffaele University (author)
  • Gulla, AisteMedStar Georgetown University Hospital,Vilnius University (author)
  • Heise, ChristianMartin-Luther-Universität Halle-Wittenberg (author)
  • Regner, SaraLund University,Lunds universitet,Kirurgi,Forskargrupper vid Lunds universitet,Surgery,Lund University Research Groups(Swepub:lu)kir-sre (author)
  • Gaujoux, SébastienParis-Sorbonne University,Pitié-Salpêtrière University Hospital (author)
  • University Of ToursLeipzig University (creator_code:org_t)

Related titles

  • In:Neuroendocrinology113:10, s. 1024-10340028-3835

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