| Title: |
Predictors of actual five-year survival and recurrence after pancreatoduodenectomy for ampullary adenocarcinoma: results from an international multicentre retrospective cohort study |
| Authors: |
Russell, TB; Labib, PL; Denson, J; Ausania, F; Pando, E; Roberts, KJ; Kausar, A; Mavroeidis, VK; Marangoni, G; Thomasset, SC; Frampton, AE; Lykoudis, P; Maglione, M; Alhaboob, N; Bari, H; Smith, AM; Spalding, D; Srinivasan, P; Davidson, BR; Bhogal, RH; Croagh, D; Dominguez, I; Thakkar, R; Gomez, D; Silva, MA; Lapolla, P; Mingoli, A; Porcu, A; Shah, NS; Hamady, ZZR; Al-Sarrieh, B; Serrablo, A; Aroori, S; Streeter, A; Puckett, M; Browning, MG; Gonzalez-Abos, C; Fernandes, N; Moller, EG; Taboada, CD; Pande, R; Alfarah, J; Bandyopadhyay, S; Abdelrahim, A; Khan, A; Jordan, C; Rees, JRE; Blege, CH; Thomasset, S; Cambridge, W; White, O; Frampton, A; Blacker, S; Blackburn, J; Sweeney, C; Field, D; Gouda, M; Bellotti, R; Hamid, HKS; Ahmed, H; Smith, A; Moriarty, C; White, L; Priestley, M; Bode, K; Sharp, J; Wragg, R; Jackson, B; Craven, S; Fehervari, M; Pai, M; Alghazawi, L; Onifade, A; Ribaud, J; Nair, A; Mariathasan, M; Grayson, N; Davidson, B; Pericleous, S; Patel, K; Shaw, C; Morare, N; Zaban, MK; Bhogal, R; Doyle, J; Guerrero, A; Moguel, A; Chan, C; Jones, M; Buckley, E; Akter, N; Treherne, K; Gordon, G; Silva, M; Hughes, D; Urbonas, T; Brachini, G; Caronna, R; Chirletti, P; Perra, T |
| Source: |
HPB , 25 (7) pp. 788-797. (2023) |
| Publisher Information: |
ELSEVIER SCI LTD |
| Publication Year: |
2023 |
| Collection: |
University College London: UCL Discovery |
| Subject Terms: |
Cholangiocarcinoma; Hepatectomy; Transplantation |
| Description: |
BACKGROUND: Pancreatoduodenectomy (PD) is recommended in fit patients with a resectable ampullary adenocarcinoma (AA). We aimed to identify predictors of five-year recurrence/survival. METHODS: Data were extracted from the Recurrence After Whipple's (RAW) study, a multicentre retrospective study of PD patients with a confirmed head of pancreas or periampullary malignancy (June 1st, 2012–May 31st, 2015). Patients with AA who developed recurrence/died within five-years were compared to those who did not. RESULTS: 394 patients were included and actual five-year survival was 54%. Recurrence affected 45% and the median time-to-recurrence was 14 months. Local only, local and distant, and distant only recurrence affected 34, 41 and 94 patients, respectively (site unknown: 7). Among those with recurrence, the most common sites were the liver (32%), local lymph nodes (14%) and lung/pleura (13%). Following multivariable tests, number of resected nodes, histological T stage > II, lymphatic invasion, perineural invasion (PNI), peripancreatic fat invasion (PPFI) and ≥1 positive resection margin correlated with increased recurrence and reduced survival. Furthermore, ≥1 positive margin, PPFI and PNI were all associated with reduced time-to-recurrence. CONCLUSIONS: This multicentre retrospective study of PD outcomes identified numerous histopathological predictors of AA recurrence. Patients with these high-risk features might benefit from adjuvant therapy. |
| Document Type: |
article in journal/newspaper |
| File Description: |
text |
| Language: |
English |
| Relation: |
https://discovery.ucl.ac.uk/id/eprint/10191702/3/Davidson_Cholangiocarcinoma%20review%20revision.pdf; https://discovery.ucl.ac.uk/id/eprint/10191702/ |
| Availability: |
https://discovery.ucl.ac.uk/id/eprint/10191702/3/Davidson_Cholangiocarcinoma%20review%20revision.pdf; https://discovery.ucl.ac.uk/id/eprint/10191702/ |
| Rights: |
open |
| Accession Number: |
edsbas.CB6C16B3 |
| Database: |
BASE |