Endoscopic and surgical management of non-metastatic ampullary neuroendocrine neoplasia: a multi-institutional Pancreas2000/EPC study

Elias Karam; Marcus Hollenbach; Einas Abou Ali; Francesco Auriemma; Andrea Anderloni; Louise Barbier; Giulio Belfiori; Fabrice Caillol; Stefano Crippa; Marco Del Chiaro; Charles De Ponthaud; Yanis Dahel; Massimo Falconi; Marc Giovannini; Dominik Heling; Yosuke Inoue; William R. Jarnagin; Galen Leung; Renato M. Lupinacci; Alberto Mariani; Viliam Masaryk; Rainer Christoph Miksch; Nicolas Musquer; Bertrand Napoleon; Atsushi Oba; Stefano Partelli; Maria C. Petrone; Frederic Prat; Alessandro Repici; Alain Sauvanet; Katrin Salzmann; Mark A. Schattner; Richard Schulick; Lilian Schwarz; Kevin Soares; Francois R. Souche; Stephanie Truant; Jean C. Vaillant; Tiegong Wang; Edris Wedi; Jens Werner; Tobias J. Weismueller; Doerte Wichmann; Uwe Will; Piera Zaccari; Aiste Gulla; Christian Heise; Sara Regner; Sebastien Gaujoux; Pancreas 2000 Research Group

doi:10.1159/000531712

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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

Elias Karam, Marcus Hollenbach, Einas Abou Ali, Francesco Auriemma, Andrea Anderloni, Louise Barbier, Giulio Belfiori, Fabrice Caillol, Stefano Crippa, Marco Del Chiaro, …

Neuroendocrinology, Vol.113(10), pp.1024-1034

01/10/2023

DOI: https://doi.org/10.1159/000531712

PMID: 37369186

Résumé

Endocrinology & Metabolism

Life Sciences & Biomedicine

Neurosciences

Neurosciences & Neurology

Science & Technology

Introduction: Ampullary neuroendocrine neoplasia (NEN) are rare and evidence regarding their management is scarce. This study aimed to describe clinico-pathological 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 ampullectomy (TSA) or pancreatoduodenectomy (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 tumour size was 17 mm (12 - 22), tumors were mostly grade 1 (70.8%) and pT2 (55.4%). Two (10%) EP resulted in severe ASGE adverse post procedure complications and 10 (50%) were R0. Clavien III to V 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 OS and DFS after EP, TSA and PD were 92%, 68%, 92% and 92%, 85%, 73%. Conclusion: Management of ampullary NEN is challenging. EP should not be performed in lesions larger than 1 cm or with a EUS-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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Titre: Endoscopic and surgical management of non-metastatic ampullary neuroendocrine neoplasia: a multi-institutional Pancreas2000/EPC study
Créateurs - sans rôle: Elias Karam - Tours Univ Hosp, Dept Visceral Surg Hepatobiliary Pancreat & Liver, Tours, France
Marcus Hollenbach - Univ Leipzig, Med Dept Gastroenterol Hepatol Infect Dis Pulmonol, Med Ctr, Leipzig, Germany
Einas Abou Ali - Cochin Hosp, Dept Gastroenterol Digest Oncol & Endoscopy, Paris, France
Francesco Auriemma - Human Clin & Res Hosp, Div Gastroenterol, Digest Endoscopy Unit, Milan, Italy
Andrea Anderloni - Fdn IRCCS Policlin San Matteo, Gastroenterol & Digest Endoscopy Unit, Pavia, Italy
Louise Barbier
Giulio Belfiori - Univ Vita Salute San Raffaele, San Raffaele Hosp IRCCS, Pancreas Translat & Clin Res Ctr, Dept Pancreat Surg, Milan, Italy
Fabrice Caillol - Inst Paoli Calmettes, Dept Endoscopy, Marseille, France
Stefano Crippa - Univ Vita Salute San Raffaele, San Raffaele Hosp IRCCS, Pancreas Translat & Clin Res Ctr, Dept Pancreat Surg, Milan, Italy
Marco Del Chiaro - Univ Colorado Anschutz Med Campus, Dept Surg, Colorado City, CO USA
Charles De Ponthaud - Grp Hosp Pitie Salpetriere, APHP, Dept Digest & HBP Surg, Paris, France
Yanis Dahel - Inst Paoli Calmettes, Dept Endoscopy, Marseille, France
Massimo Falconi
Marc Giovannini - Inst Paoli Calmettes, Dept Endoscopy, Marseille, France
Dominik Heling - Univ Hosp Bonn, Dept Internal Med 1, Bonn, Germany
Yosuke Inoue - Canc Inst Hosp, Dept Hepatobiliary Pancreat Surg, Tokyo, Japan
William R. Jarnagin - Mem Sloan Kettering Canc Ctr, Dept Surg, New York, NY USA
Galen Leung - Univ Penn, Div Gastroenterol & Hepatol, Perelman Sch Med, Philadelphia, PA USA
Renato M. Lupinacci - Grp Hosp Diaconesses Croix St Simon, Dept Digest Surg, Paris, France
Alberto Mariani - Univ Vita Salute San Raffaele, IRCCS San Raffaele Sci Inst, Pancreas Translat & Clin Res Ctr, Pancreato Biliary Endoscopy & Endosonog Div, Milan, Italy
Viliam Masaryk
Rainer Christoph Miksch - Ludwig Maximilian Univ Munich, Dept Gen Visceral & Transplantat Surg, Munich, Germany
Nicolas Musquer - Clin Sante Atlantique, St Herblain, France
Bertrand Napoleon - Ramsay Gen de Sante, Hop pr Jean Mermoz, Lyon, France
Atsushi Oba
Stefano Partelli
Maria C. Petrone - Univ Vita Salute San Raffaele, IRCCS San Raffaele Sci Inst, Pancreas Translat & Clin Res Ctr, Pancreato Biliary Endoscopy & Endosonog Div, Milan, Italy
Frederic Prat - Assistance Publique – Hôpitaux de Paris
Alessandro Repici
Alain Sauvanet - Beaujon Hosp, APHP, Dept Digest Surg, Clichy, France
Katrin Salzmann - Univ Med Gottingen, Dept Gastroenterol & Gastrointestinal Oncol, Gottingen, Germany
Mark A. Schattner
Richard Schulick
Lilian Schwarz - Ctr Hosp Univ Rouen, Hop Charles Nicolle, Dept Digest Surg, Rouen, France
Kevin Soares
Francois R. Souche - Ctr Hosp Univ Montpellier, Dept Digest Surg, Montpellier, France
Stephanie Truant - Ctr Hosp Univ Lille, Dept Digest Surg, Lille, France
Jean C. Vaillant
Tiegong Wang - Cangzhou Cent Hosp, Dept Surg, Cangzhou, Hebei, Peoples R China
Edris Wedi - Sana Clin Offenbach, Dept Gastroenterol Gastrointestinal Oncol & Interv, Offenbach, Germany
Jens Werner
Tobias J. Weismueller - Vivantes Humboldt Hosp, Dept Internal Med Gastroenterol & Oncol, Berlin, Germany
Doerte Wichmann - Univ Hosp Tubingen, Dept Gen Visceral & Transplantat Surg, Tubingen, Germany
Uwe Will - SRH Wald Klinikum Gera, Dept Gastroenterol Hepatol Diabet & Gen Internal M, Gera, Germany
Piera Zaccari
Aiste Gulla - Vilnius Univ, Inst Med, Fac Med, Vilnius, Lithuania
Christian Heise - Martin Luther Univ Halle Wittenberg, Dept Med Gastroenterol Pulmonol 1, Halle, Germany
Sara Regner - Lund Univ, Dept Clin Sci Malmo, Sect Surg, Lund, Sweden
Sebastien Gaujoux - Hop La Pitie Salpetriere, AP HP, Dept Hepatobiliary & Pancreat Surg & Liver Transpl, Paris, AP, Brazil
Pancreas 2000 Research Group
Détails de publication: Neuroendocrinology, Vol.113(10), pp.1024-1034
Éditeur: Karger
Nombre de pages: 11
Note de subvention: European Pancreatic Club (EPC) Karolinska Institute; Karolinska Institutet
Identifiants: 99140051209311
Unité académique: Institut de Recherche en Cancérologie de Montpellier - IRCM
Langue: English
Type de ressource: Journal article