Katsunori Matsueda1, Hiromitsu Kanzaki1, Kazuhiro Matsueda2, Junichiro Nasu3, Masao Yoshioka3, Masahiro Nakagawa4, Masafumi Inoue5, Tomoki Inaba6, Atsushi Imagawa7, Masahiro Takatani8, Ryuta Takenaka9, Seiyu Suzuki10, Jun Tomoda11, Takahito Yagi12, Toshiyoshi Fujiwara13, Takehiro Tanaka14, Hiroyuki Okada1. 1. Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan. 2. Department of Gastroenterology and Hepatology, Kurashiki Central Hospital, Kurashiki, Japan. 3. Department of Internal Medicine, Okayama Saiseikai General Hospital, Okayama, Japan. 4. Department of Endoscopy, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan. 5. Department of Gastroenterology, Japanese Red Cross Okayama Hospital, Okayama, Japan. 6. Department of Gastroenterology, Kagawa Prefectural Central Hospital, Takamatsu, Japan. 7. Department of Gastroenterology, Mitoyo General Hospital, Kanonji, Japan. 8. Department of Internal Medicine, Japanese Red Cross Society Himeji Hospital, Himeji, Japan. 9. Department of Internal Medicine, Tsuyama Chuo Hospital, Tsuyama, Japan. 10. Department of Internal Medicine, Sumitomo Besshi Hospital, Niihama, Japan. 11. Department of Internal Medicine, Akaiwa Medical Association Hospital, Okayama, Japan. 12. Department of Hepato-Biliary-Pancreatic Surgery, Okayama University Hospital, Okayama, Japan. 13. Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan. 14. Department of Pathology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
Abstract
BACKGROUND AND AIM: Although sporadic non-ampullary duodenal adenoma is speculated to be precancerous lesion, the relationship between adenoma and carcinoma remains unclear due to their rarity. Previous studies on sporadic non-ampullary duodenal epithelial neoplasm (SNADEN) have mainly targeted superficial tumors, like adenoma and early carcinoma. The clinicopathological features, including those of advanced carcinoma, remain poorly investigated. We assessed the clinicopathological features of SNADEN, including advanced carcinoma, focusing on tumor location. METHODS: We retrospectively collected the data of 410 patients who had been clinically and pathologically diagnosed with SNADEN at 11 institutions in Japan between June 2002 and March 2014. RESULTS: The SNADEN was mucosal neoplasia and invasive carcinoma in 321 (78.3%) and 89 (21.7%) patients, respectively. The proportion of invasive carcinomas in SNADEN was significantly higher on the oral side of the papilla of Vater (oral-Vater) than on the anal side (anal-Vater) (27.9% vs 14.4%, P < 0.001). Undifferentiated-type carcinoma was significantly more frequent with oral-Vater than anal-Vater (38.7% vs 14.8%, P = 0.026). The recurrence rate of surgically R0 resected locally advanced carcinomas was significantly higher with oral-Vater than anal-Vater (46.4% vs 8.3%, P = 0.021). Furthermore, the relapse-free survival with oral-Vater was significantly shorter than with anal-Vater (hazard ratio: 2.35; 95% confidence interval: 1.09-5.50; P = 0.028). CONCLUSIONS: The clinicopathological features of SNADEN on oral-Vater were different from those on anal-Vater. SNADEN on oral-Vater was more likely to be invasive carcinomas and might behave more aggressively due to biologically higher malignancy than that on anal-Vater.
BACKGROUND AND AIM: Although sporadic non-ampullary duodenal adenoma is speculated to be precancerous lesion, the relationship between adenoma and carcinoma remains unclear due to their rarity. Previous studies on sporadic non-ampullary duodenal epithelial neoplasm (SNADEN) have mainly targeted superficial tumors, like adenoma and early carcinoma. The clinicopathological features, including those of advanced carcinoma, remain poorly investigated. We assessed the clinicopathological features of SNADEN, including advanced carcinoma, focusing on tumor location. METHODS: We retrospectively collected the data of 410 patients who had been clinically and pathologically diagnosed with SNADEN at 11 institutions in Japan between June 2002 and March 2014. RESULTS: The SNADEN was mucosal neoplasia and invasive carcinoma in 321 (78.3%) and 89 (21.7%) patients, respectively. The proportion of invasive carcinomas in SNADEN was significantly higher on the oral side of the papilla of Vater (oral-Vater) than on the anal side (anal-Vater) (27.9% vs 14.4%, P < 0.001). Undifferentiated-type carcinoma was significantly more frequent with oral-Vater than anal-Vater (38.7% vs 14.8%, P = 0.026). The recurrence rate of surgically R0 resected locally advanced carcinomas was significantly higher with oral-Vater than anal-Vater (46.4% vs 8.3%, P = 0.021). Furthermore, the relapse-free survival with oral-Vater was significantly shorter than with anal-Vater (hazard ratio: 2.35; 95% confidence interval: 1.09-5.50; P = 0.028). CONCLUSIONS: The clinicopathological features of SNADEN on oral-Vater were different from those on anal-Vater. SNADEN on oral-Vater was more likely to be invasive carcinomas and might behave more aggressively due to biologically higher malignancy than that on anal-Vater.
Authors: Eun Young Kim; Dong Jin Kim; Han Hong Lee; Jun Hyun Lee; Jeong Goo Kim; Kyo Young Song; Jin Jo Kim; Hyung Min Chin; Wook Kim Journal: Ann Surg Treat Res Date: 2022-05-03 Impact factor: 1.766
Authors: Jana Tesarikova; Pavel Skalicky; Daniela Kurfurstova; Hana Svebisova; Ondrej Urban; Premysl Falt; Jana Zapletalova; Dusan Klos; Martin Lovecek Journal: Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub Date: 2021-05-11 Impact factor: 1.648