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. 2024 Mar;31(3):203-212.
doi: 10.1002/jhbp.1398. Epub 2023 Nov 28.

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

Ko Suzuki  1 , Yusuke Kurita  1 , Kensuke Kubota  1 , Yuji Fujita  2 , Seitaro Tsujino  2 , Yuji Koyama  2 , Shintaro Tsujikawa  2 , Shigeki Tamura  1 , Shin Yagi  1 , Sho Hasegawa  1 , Takamitsu Sato  1 , Kunihiro Hosono  1 , Noritoshi Kobayashi  3 , Hiromichi Iwashita  4 , Shoji Yamanaka  4 , Satoshi Fujii  4 , Itaru Endo  5 , Atsushi Nakajima  1
Affiliations

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

Ko Suzuki et al. J Hepatobiliary Pancreat Sci. 2024 Mar.

Abstract

Background/purpose: There 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.

Methods: Patients 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.

Results: Adenocarcinoma 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.

Conclusions: EP may potentially achieve clinical complete resection of early stage (Tis and T1a) duodenal ampullary adenocarcinomas.

Keywords: adenocarcinoma; ampullary carcinoma; ampullary tumor; carcinoma in situ; endoscopic papillectomy.

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References

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