Molecular pathways in periampullary cancer: An overview

Apurva,; Sattar, Real Sumayya Abdul; Ali, Asgar; Nimisha,; Sharma, Abhay; Arunkumar,; Santoshi, Seneha; Saluja, Sundeep Singh

doi:10.1016/j.cellsig.2022.110461

Cited by 5 publications

(2 citation statements)

References 98 publications

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“…To date, there is only marginal research on molecular classification, yet its potential significance in enhancing the categorization of periampullary cancers cannot be overlooked. A molecular classification approach, utilizing specific tumor markers such as CK7, CK20, MUC1, MUC2, and CDX2, and genes like KRAS, TP53, APC, and PIK3CA, could prove pivotal in refining the classification methodology [ 29 , 30 ]. However, it is important to note that, as of now, there is no standardized technique for the implementation of tumor markers.…”

Section: Discussionmentioning

confidence: 99%

Different Periampullary Types and Subtypes Leading to Different Perioperative Outcomes of Pancreatoduodenectomy: Reality and Not a Myth; An International Multicenter Cohort Study

Uijterwijk,

Lemmers,

Fusai

et al. 2024

Cancers

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This international multicenter cohort study included 30 centers. Patients with duodenal adenocarcinoma (DAC), intestinal-type (AmpIT) and pancreatobiliary-type (AmpPB) ampullary adenocarcinoma, distal cholangiocarcinoma (dCCA), and pancreatic ductal adenocarcinoma (PDAC) were included. The primary outcome was 30-day or in-hospital mortality, and secondary outcomes were major morbidity (Clavien-Dindo 3b≥), clinically relevant post-operative pancreatic fistula (CR-POPF), and length of hospital stay (LOS). Results: Overall, 3622 patients were included in the study (370 DAC, 811 AmpIT, 895 AmpPB, 1083 dCCA, and 463 PDAC). Mortality rates were comparable between DAC, AmpIT, AmpPB, and dCCA (ranging from 3.7% to 5.9%), while lower for PDAC (1.5%, p = 0.013). Major morbidity rate was the lowest in PDAC (4.4%) and the highest for DAC (19.9%, p < 0.001). The highest rates of CR-POPF were observed in DAC (27.3%), AmpIT (25.5%), and dCCA (27.6%), which were significantly higher compared to AmpPB (18.5%, p = 0.001) and PDAC (8.3%, p < 0.001). The shortest LOS was found in PDAC (11 d vs. 14–15 d, p < 0.001). Discussion: In conclusion, this study shows significant variations in perioperative mortality, post-operative complications, and hospital stay among different periampullary cancers, and between the ampullary subtypes. Further research should assess the biological characteristics and tissue reactions associated with each type of periampullary cancer, including subtypes, in order to improve patient management and personalized treatment.

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Section: Discussionmentioning

confidence: 99%

Different Periampullary Types and Subtypes Leading to Different Perioperative Outcomes of Pancreatoduodenectomy: Reality and Not a Myth; An International Multicenter Cohort Study

Uijterwijk,

Lemmers,

Fusai

et al. 2024

Cancers

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“…In our cohort, the median survival of the patients was 24 months, and pancreatic head cancer had a poor survival outcome as compared to other periampullary cancers. This may be because pancreatic cancer is known to be a biologically more aggressive tumor and has a higher incidence of nodal spread, perineural invasion, and lymphovascular invasion [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

Predictive Factors Associated With Survival in Periampullary Cancers Following Pancreaticoduodenectomy: A Retrospective Analysis

Maharjan,

Bhandari,

Lakhey

2023

Cureus

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Background Periampullary cancers arise from four different anatomical sites and are in close proximity. But they have different survival outcomes. There are various clinicopathological factors associated with survival after pancreaticoduodenectomy done for periampullary cancers. So, we aimed to identify the predictive factors associated with poor survival in periampullary cancers at Tribhuvan University Teaching Hospital, Kathmandu, Nepal. Methods We analyzed the medical records of patients who underwent pancreaticoduodenectomy (PD) at Tribhuvan University Teaching Hospital, Kathmandu, from April 2004 to May 2014. Demography, clinicopathological features, and survival outcomes were analyzed retrospectively. Results This study included 61 patients. The mean age of patients was 56.2 ± 14.2 years, and there was a male preponderance (M:F = 1.4). The median survival of all patients was 24 months. Non-pancreatic periampullary cancer patients had better median survival as compared to pancreatic cancer patients (24 vs. 8 months, p = 0.03). The presence of lymphovascular invasion (LVI), peripheral invasion (PNI), nodal involvement, and a higher lymph node ratio (LNR) were associated with poor median survival. However, perineural invasion was the only factor associated with poor survival in multivariate analysis. Conclusion The presence of perineural invasion is associated with poor survival outcomes in patients with periampullary cancer following pancreaticoduodenectomy. Also, carcinoma of the head of the pancreas has poor survival as compared to other periampullary cancers.

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