Melroy A D'Souza1, Valentinus T Valdimarsson2, Tommaso Campagnaro3, Francois Cauchy4, Nikolaos A Chatzizacharias5, Mathieu D'Hondt6, Bobby Dasari5, Alessandro Ferrero7, Lotte C Franken8, Giuseppe Fusai9, Alfredo Guglielmi3, Jeroen Hagendoorn10, Camila Hidalgo Salinas9, Frederik J H Hoogwater11, Rosa Jorba12, Nariman Karanjia13, Wolfram T Knoefel14, Philipp Kron15, Rajiv Lahiri13, Serena Langella7, Bertrand Le Roy4, Nadja Lehwald-Tywuschik14, Mickael Lesurtel16, Jun Li17, J Peter A Lodge15, Erini Martinou13, Izaak Q Molenaar10, Andrej Nikov18, Ignasi Poves19, Fadi Rassam8, Nadia Russolillo7, Olivier Soubrane4, Stefan Stättner20, Ronald M van Dam21, Thomas M van Gulik8, Alejandro Serrablo22, Tom M Gallagher23, Christian Sturesson24. 1. Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden. 2. Department of Clinical Sciences Lund, Surgery, Lund University, Skane University Hospital, Lund, Sweden. 3. Department of Surgery, General and Hepatobiliary Surgery Unit, Verona University Hospital, Verona, Italy. 4. Department of HPB Surgery and Liver Transplantation, Beaujon Hospital, Clichy, France. 5. Department of Hepatobiliary and Pancreatic Surgery, Queen Elizabeth Hospital, Birmingham, United Kingdom. 6. Department of Digestive and Hepatobiliary/Pancreatic Surgery, AZ Groeninge Kortrijk, Belgium. 7. Department of HPB and Digestive Surgery, Ospedale Mauriziano Umberto I, Turin, Italy. 8. Department of Surgery, Amsterdam University Medical Centres, location AMC, Amsterdam, the Netherlands. 9. Department of HPB and Liver Transplant Surgery, Royal Free Hospital, NHS Foundation Trust, London, United Kingdom. 10. Department of Surgery, University Medical Center Utrecht, Utrecht, the Netherlands. 11. Department of Surgery, Division of Hepatopancreatobiliary Surgery and Liver Transplantation, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands. 12. Hepatobiliary and Pancreatic Surgery Unit, General Surgery Department, Joan XXIII University Hospital, Tarragona, Spain. 13. Surrey and Sussex Regional HPB Unit, Royal Surrey County Hospital, Guildford, United Kingdom. 14. Department of Surgery (A), Heinrich-Heine-University and University Hospital Düsseldorf, Düsseldorf, Germany. 15. Department of Hepatobiliary Surgery, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom. 16. Department of Surgery and Liver Transplantation, Croix-Rousse University Hospital, University of Lyon, Lyon, France. 17. Department of Hepatobiliary Surgery and Visceral Transplantation, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. 18. Department of Surgery, 2 Faculty of Medicine, Charles University and Central Military Hospital, Prague, 16002, Czech Republic. 19. Department of Surgery, Hospital del Mar, Barcelona, Spain. 20. Department of Visceral, Transplantation and Thoracic Surgery, Medical University of Innsbruck, Innsbruck, Austria. 21. Department of Surgery, Maastricht University Medical Center, Maastricht, the Netherlands. 22. Hepatobiliopancreatic Surgery Unit, General and Digestive Surgery Service, Hospital Miguel Servet, Zaragoza, Spain. 23. Department of Hepatobiliary and Transplant Surgery St Vincent's University Hospital Elm Park, Dublin, Ireland. 24. Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden. Electronic address: christian.sturesson@sll.se.
Abstract
BACKGROUND: Hepatopancreatoduodenectomy (HPD) is an aggressive operation for treatment of advanced bile duct and gallbladder cancer associated with high perioperative morbidity and mortality, and uncertain oncological benefit in terms of survival. Few reports on HPD from Western centers exist. The purpose of this study was to evaluate safety and efficacy for HPD in European centers. METHOD: Members of the European-African HepatoPancreatoBiliary Association were invited to report all consecutive patients operated with HPD for bile duct or gallbladder cancer between January 2003 and January 2018. The patient and tumor characteristics, perioperative and survival outcomes were analyzed. RESULTS: In total, 66 patients from 19 European centers were included in the analysis. 90-day mortality rate was 17% and 13% for bile duct and gallbladder cancer respectively. All factors predictive of perioperative mortality were patient and disease-specific. The three-year overall survival excluding 90-day mortality was 80% for bile duct and 30% for gallbladder cancer (P = 0.013). In multivariable analysis R0-resection had a significant impact on overall survival. CONCLUSION: HPD, although being associated with substantial perioperative mortality, can offer a survival benefit in patient subgroups with bile duct cancer and gallbladder cancer. To achieve negative resection margins is paramount for an improved survival outcome.
BACKGROUND: Hepatopancreatoduodenectomy (HPD) is an aggressive operation for treatment of advanced bile duct and gallbladder cancer associated with high perioperative morbidity and mortality, and uncertain oncological benefit in terms of survival. Few reports on HPD from Western centers exist. The purpose of this study was to evaluate safety and efficacy for HPD in European centers. METHOD: Members of the European-African HepatoPancreatoBiliary Association were invited to report all consecutive patients operated with HPD for bile duct or gallbladder cancer between January 2003 and January 2018. The patient and tumor characteristics, perioperative and survival outcomes were analyzed. RESULTS: In total, 66 patients from 19 European centers were included in the analysis. 90-day mortality rate was 17% and 13% for bile duct and gallbladder cancer respectively. All factors predictive of perioperative mortality were patient and disease-specific. The three-year overall survival excluding 90-day mortality was 80% for bile duct and 30% for gallbladder cancer (P = 0.013). In multivariable analysis R0-resection had a significant impact on overall survival. CONCLUSION: HPD, although being associated with substantial perioperative mortality, can offer a survival benefit in patient subgroups with bile duct cancer and gallbladder cancer. To achieve negative resection margins is paramount for an improved survival outcome.
Authors: Moath Alarabiyat; Syed Soulat Raza; John Isaac; Darius Mirza; Ravi Marudanayagam; Keith Roberts; Manuel Abradelo; David C Bartlett; Bobby V Dasari; Robert P Sutcliffe; Nikolaos A Chatzizacharias Journal: World J Gastroenterol Date: 2022-05-14 Impact factor: 5.374
Authors: Lynn E Nooijen; Rutger-Jan Swijnenburg; Heinz-Josef Klümpen; Joanne Verheij; Geert Kazemier; Thomas M van Gulik; Joris I Erdmann Journal: Visc Med Date: 2021-01-07
Authors: Pietro Addeo; Caterina Cusumano; Bernard Goichot; Martina Guerra; François Faitot; Alessio Imperiale; Philippe Bachellier Journal: Cancers (Basel) Date: 2022-01-30 Impact factor: 6.639