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Comparison of Oncologic Outcomes between Transduodenal Ampullectomy and Pancreatoduodenectomy in Ampulla of Vater Cancer: Korean Multicenter Study

Authors
 Seung-Soo Hong  ;  Sung-Sik Han  ;  Wooil Kwon  ;  Jin-Young Jang  ;  Hee-Joon Kim  ;  Chol-Kyoon Cho  ;  Keun-Soo Ahn  ;  Jae-Do Yang  ;  Youngmok Park  ;  Seog-Ki Min  ;  Ju-Ik Moon  ;  Young-Hoon Roh  ;  Seung-Eun Lee  ;  Joon-Seong Park  ;  Sang-Geol Kim  ;  Chi-Young Jeong  ;  Jin-Seok Heo  ;  Ho-Kyoung Hwang 
Citation
 CANCERS, Vol.13(9) : 2038, 2021-04 
Journal Title
 CANCERS 
Issue Date
2021-04
Keywords
ampulla of Vater cancer ; pancreaticoduodenectomy ; transduodenal ampullectomy
Abstract
This study used multicenter data to compare the oncological safety of transduodenal ampullectomy (TDA) with that of pylorus-preserving pancreatoduodenectomy (PPPD) in early ampulla of Vater (AoV) cancer. Data for patients who underwent surgical resection for AoV cancer (pTis-T2 stage) from January 2000 to September 2019 were collected from 15 institutions. The clinicopathologic characteristics and survival outcomes were compared between the PPPD and TDA groups. A total of 486 patients were enrolled (PPPD, 418; TDA, 68). The oncologic behavior in the PPPD group was more aggressive than that in the TDA group at all T stages: larger tumor size (p = 0.034), advanced T stage (p < 0.001), aggressive cell differentiation (p < 0.001), and more lymphovascular invasion (p = 0.002). Five-year disease-free survival (DFS) and overall survival (OS) did not differ between the two groups when considering all T stages or only the Tis+T1 group. Among T1 patients, PPPD produced significantly better DFS (PPPD vs. TDA, 84.8% vs. 66.6%, p = 0.040) and superior OS (PPPD vs. TDA, 89.1% vs. 68.0%, p = 0.056) than TDA. Lymph node dissection (LND) in the TDA group did not affect DFS or OS (TDA + LND vs. TDA-only, DFS, p = 0.784; OS, p = 0.870). In conclusion, PPPD should be the standard procedure for early AoV cancer.
Files in This Item:
T202101582.pdf Download
DOI
10.3390/cancers13092038
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Park, Joon Seong(박준성) ORCID logo https://orcid.org/0000-0001-8048-9990
Hong, Seung Soo(홍승수)
Hwang, Ho Kyoung(황호경) ORCID logo https://orcid.org/0000-0003-4064-7776
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/182921
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