Endoscopic papillectomy could be rewarding to patients with early stage duodenal ampullary carcinoma?

Author:

Suzuki Ko1,Kurita Yusuke1ORCID,Kubota Kensuke1ORCID,Fujita Yuji2,Tsujino Seitaro2,Koyama Yuji2,Tsujikawa Shintaro2,Tamura Shigeki1,Yagi Shin1ORCID,Hasegawa Sho1ORCID,Sato Takamitsu1,Hosono Kunihiro1ORCID,Kobayashi Noritoshi3ORCID,Iwashita Hiromichi4,Yamanaka Shoji4,Fujii Satoshi4,Endo Itaru5ORCID,Nakajima Atsushi1

Affiliation:

1. Department of Gastroenterology and Hepatology Yokohama City University School of Medicine Yokohama Japan

2. Department of Oncology Yokohama City University School of Medicine Yokohama Japan

3. Department of Gastroenterological Surgery Yokohama City University School of Medicine Yokohama Japan

4. Department of Hepato‐Biliary‐Pancreatic Medicine NTT Medical Center Tokyo Tokyo Japan

5. Department of Pathology Yokohama City University School of Medicine Yokohama Japan

Abstract

AbstractBackground/PurposeThere is currently no consensus on the use of endoscopic papillectomy (EP) for early stage duodenal ampullary adenocarcinoma. This study aimed to evaluate the feasibility of EP for patients with early stage duodenal ampullary adenocarcinoma.MethodsPatients who underwent EP for ampullary adenocarcinomas were investigated. Complete and clinical complete resection rates were evaluated. Clinical complete resection was defined as either complete resection or resection with positive or unknown margins but no cancer in the surgically resected specimen, or no recurrence on endoscopy after at least a 1‐year follow‐up.ResultsAdenocarcinoma developed in 30 patients (carcinoma in situ [Tis]: 21, mucosal tumors [T1a(M)]: 4, tumors in the sphincter of Oddi [T1a(OD)]: 5). The complete resection rate was 60.0% (18/30) (Tis: 66.7% [14/21], T1a[M]: 50.0% [2/4], and T1a[OD]: 40.0% [2/5]). The mean follow‐up period was 46.8 months. The recurrence rate for all patients was 6.7% (2/30). The clinical complete resection rates of adenocarcinoma were 89.2% (25/28); rates for Tis, T1a(M), and T1a(OD) were 89.4% (17/19), 100% (4/4), and 80% (4/5), respectively.ConclusionsEP may potentially achieve clinical complete resection of early stage (Tis and T1a) duodenal ampullary adenocarcinomas.

Publisher

Wiley

Subject

Hepatology,Surgery

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