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Hepatopancreatoduodenectomy -a controversial treatment for bile duct and gallbladder cancer from a European perspective
MA. D'Souza, VT. Valdimarsson, T. Campagnaro, F. Cauchy, NA. Chatzizacharias, M. D'Hondt, B. Dasari, A. Ferrero, LC. Franken, G. Fusai, A. Guglielmi, J. Hagendoorn, C. Hidalgo Salinas, FJH. Hoogwater, R. Jorba, N. Karanjia, WT. Knoefel, P. Kron,...
Jazyk angličtina Země Velká Británie
Typ dokumentu časopisecké články
- MeSH
- hepatektomie MeSH
- lidé MeSH
- nádory žlučníku * chirurgie MeSH
- nádory žlučových cest * chirurgie MeSH
- pankreatoduodenektomie škodlivé účinky MeSH
- žlučové cesty intrahepatální MeSH
- žlučové cesty MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
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.
Department of Clinical Sciences Lund Surgery Lund University Skane University Hospital Lund Sweden
Department of Digestive and Hepatobiliary Pancreatic Surgery AZ Groeninge Kortrijk Belgium
Department of Hepatobiliary Surgery Leeds Teaching Hospitals NHS Trust Leeds United Kingdom
Department of HPB and Digestive Surgery Ospedale Mauriziano Umberto 1 Turin Italy
Department of HPB Surgery and Liver Transplantation Beaujon Hospital Clichy France
Department of Surgery Amsterdam University Medical Centres location AMC Amsterdam the Netherlands
Department of Surgery General and Hepatobiliary Surgery Unit Verona University Hospital Verona Italy
Department of Surgery Hospital del Mar Barcelona Spain
Department of Surgery Maastricht University Medical Center Maastricht the Netherlands
Department of Surgery University Medical Center Utrecht Utrecht the Netherlands
Surrey and Sussex Regional HPB Unit Royal Surrey County Hospital Guildford United Kingdom
Citace poskytuje Crossref.org
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- $a Hepatopancreatoduodenectomy -a controversial treatment for bile duct and gallbladder cancer from a European perspective / $c MA. D'Souza, VT. Valdimarsson, T. Campagnaro, F. Cauchy, NA. Chatzizacharias, M. D'Hondt, B. Dasari, A. Ferrero, LC. Franken, G. Fusai, A. Guglielmi, J. Hagendoorn, C. Hidalgo Salinas, FJH. Hoogwater, R. Jorba, N. Karanjia, WT. Knoefel, P. Kron, R. Lahiri, S. Langella, B. Le Roy, N. Lehwald-Tywuschik, M. Lesurtel, J. Li, JPA. Lodge, E. Martinou, IQ. Molenaar, A. Nikov, I. Poves, F. Rassam, N. Russolillo, O. Soubrane, S. Stättner, RM. van Dam, TM. van Gulik, A. Serrablo, TM. Gallagher, C. Sturesson, E-AHPBA scientific and research committee
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- $a 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.
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