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Hepatopancreatoduodenectomy –a controversial treatment for bile duct and gallbladder cancer from a European perspective

D'Souza, Melroy A. ; Valdimarsson, Valentinus T. LU orcid ; Campagnaro, Tommaso ; Cauchy, Francois ; Chatzizacharias, Nikolaos A. ; D'Hondt, Mathieu ; Dasari, Bobby ; Ferrero, Alessandro ; Franken, Lotte C. and Fusai, Giuseppe , et al. (2020) In HPB 22(9). p.1339-1348
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... (More)

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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publication status
published
subject
in
HPB
volume
22
issue
9
pages
10 pages
publisher
Elsevier
external identifiers
  • scopus:85077160202
  • pmid:31899044
ISSN
1365-182X
DOI
10.1016/j.hpb.2019.12.008
language
English
LU publication?
yes
id
44513f7b-2ec2-40d6-8ec0-514890aa1305
date added to LUP
2020-01-17 10:39:14
date last changed
2024-04-17 02:05:42
@article{44513f7b-2ec2-40d6-8ec0-514890aa1305,
  abstract     = {{<p>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.</p>}},
  author       = {{D'Souza, Melroy A. and Valdimarsson, Valentinus T. and Campagnaro, Tommaso and Cauchy, Francois and Chatzizacharias, Nikolaos A. and D'Hondt, Mathieu and Dasari, Bobby and Ferrero, Alessandro and Franken, Lotte C. and Fusai, Giuseppe and Guglielmi, Alfredo and Hagendoorn, Jeroen and Hidalgo Salinas, Camila and Hoogwater, Frederik J.H. and Jorba, Rosa and Karanjia, Nariman and Knoefel, Wolfram T. and Kron, Philipp and Lahiri, Rajiv and Langella, Serena and Le Roy, Bertrand and Lehwald-Tywuschik, Nadja and Lesurtel, Mickael and Li, Jun and Lodge, J. Peter A. and Martinou, Erini and Molenaar, Izaak Q. and Nikov, Andrej and Poves, Ignasi and Rassam, Fadi and Russolillo, Nadia and Soubrane, Olivier and Stättner, Stefan and van Dam, Ronald M. and van Gulik, Thomas M. and Serrablo, Alejandro and Gallagher, Tom M. and Sturesson, Christian}},
  issn         = {{1365-182X}},
  language     = {{eng}},
  month        = {{09}},
  number       = {{9}},
  pages        = {{1339--1348}},
  publisher    = {{Elsevier}},
  series       = {{HPB}},
  title        = {{Hepatopancreatoduodenectomy –a controversial treatment for bile duct and gallbladder cancer from a European perspective}},
  url          = {{http://dx.doi.org/10.1016/j.hpb.2019.12.008}},
  doi          = {{10.1016/j.hpb.2019.12.008}},
  volume       = {{22}},
  year         = {{2020}},
}