TY - JOUR
T1 - Hepatopancreatoduodenectomy –a controversial treatment for bile duct and gallbladder cancer from a European perspective
AU - E-AHPBA scientific and research committee
AU - D'Souza, Melroy A.
AU - Valdimarsson, Valentinus T.
AU - Campagnaro, Tommaso
AU - Cauchy, Francois
AU - Chatzizacharias, Nikolaos A.
AU - D'Hondt, Mathieu
AU - Dasari, Bobby
AU - Ferrero, Alessandro
AU - Franken, Lotte C.
AU - Fusai, Giuseppe
AU - Guglielmi, Alfredo
AU - Hagendoorn, Jeroen
AU - Hidalgo Salinas, Camila
AU - Hoogwater, Frederik J. H.
AU - Jorba, Rosa
AU - Karanjia, Nariman
AU - Knoefel, Wolfram T.
AU - Kron, Philipp
AU - Lahiri, Rajiv
AU - Langella, Serena
AU - le Roy, Bertrand
AU - Lehwald-Tywuschik, Nadja
AU - Lesurtel, Mickael
AU - Li, Jun
AU - Lodge, J. Peter A.
AU - Martinou, Erini
AU - Molenaar, Izaak Q.
AU - Nikov, Andrej
AU - Poves, Ignasi
AU - Rassam, Fadi
AU - Russolillo, Nadia
AU - Soubrane, Olivier
AU - Stättner, Stefan
AU - van Dam, Ronald M.
AU - van Gulik, Thomas M.
AU - Serrablo, Alejandro
AU - Gallagher, Tom M.
AU - Sturesson, Christian
N1 - Publisher Copyright: © 2019 International Hepato-Pancreato-Biliary Association Inc. Copyright: Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020/9
Y1 - 2020/9
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=85077160202&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.hpb.2019.12.008
DO - https://doi.org/10.1016/j.hpb.2019.12.008
M3 - Article
C2 - 31899044
SN - 1365-182X
VL - 22
SP - 1339
EP - 1348
JO - HPB: The official journal of the International Hepato Pancreato Biliary Association
JF - HPB: The official journal of the International Hepato Pancreato Biliary Association
IS - 9
ER -