Title :

Limited Resection Versus Pancreaticoduodenectomy for Duodenal Gastrointestinal Stromal Tumors? Enucleation Interferes in the Debate: A European Multicenter Retrospective Cohort Study.

Author(s) :

Dubois, C. [Auteur]
Nuytens, F. [Auteur]
Behal, Helene [Auteur]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Gronnier, C. [Auteur]
Manceau, G. [Auteur]
Warlaumont, M. [Auteur]
Duhamel, Alain [Auteur]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Denost, Q. [Auteur]
Honoré, C. [Auteur]
Facy, O. [Auteur]
Tuech, J. J. [Auteur]
Tiberio, G. [Auteur]
Brigand, C. [Auteur]
Bail, J. P. [Auteur]
Salame, E. [Auteur]
Meunier, B. [Auteur]
Lefevre, J. H. [Auteur]
Mathonnet, M. [Auteur]
Idrissi, M. S. [Auteur]
Renaud, Florence [Auteur]
Cancer Heterogeneity, Plasticity and Resistance to Therapies (CANTHER) - UMR 9020 - UMR 1277
Piessen, Guillaume [Auteur]
Cancer Heterogeneity, Plasticity and Resistance to Therapies (CANTHER) - UMR 9020 - UMR 1277
Dubois, Clément [Auteur]

Journal title :

Annals of Surgical Oncology

Abbreviated title :

Ann Surg Oncol

Volume number :

28

Pages :

p. 6294–6306

Publication date :

2021-04-10

ISSN :

1534-4681

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

Background The optimal surgical procedure for duodenal gastrointestinal stromal tumors (D-GISTs) remains poorly defined. Pancreaticoduodenectomy (PD) allows for a wide resection but is associated with a high morbidity ...
Show more >Background The optimal surgical procedure for duodenal gastrointestinal stromal tumors (D-GISTs) remains poorly defined. Pancreaticoduodenectomy (PD) allows for a wide resection but is associated with a high morbidity rate. Objectives The aim of this study was to compare the short- and long-term outcomes of PD versus limited resection (LR) for D-GISTs and to evaluate the role of tumor enucleation (EN). Methods In this retrospective European multicenter cohort study, 100 patients who underwent resection for D-GIST between 2001 and 2013 were compared between PD (n = 19) and LR (n = 81). LR included segmental duodenectomy (n = 47), wedge resection (n = 21), or EN (n = 13). The primary objective was to evaluate disease-free survival (DFS) between the groups, while the secondary objectives were to analyze the overall morbidity and mortality, radicality of resection, and 5-year overall survival (OS) and recurrence rates between groups. Furthermore, the short- and long-term outcomes of EN were evaluated. Results Baseline characteristics were comparable between the PD and LR groups, except for a more frequent D2 tumor location in the PD group (68.3% vs. 29.6%; p = 0.016). Postoperative morbidity was higher after PD (68.4% vs. 23.5%; p < 0.001). OS (p = 0.70) and DFS (p = 0.64) were comparable after adjustment for D2 location and adjuvant therapy rate. EN was performed more in American Society of Anesthesiologists (ASA) stage III/IV patients with tumors < 5 cm and was associated with a 5-year OS rate of 84.6%, without any disease recurrences. Conclusions For D-GISTs, LR should be the procedure of choice due to lower morbidity and similar oncological outcomes compared with PD. In selected patients, EN appears to be associated with equivalent short- and long-term outcomes. Based on these results, a surgical treatment algorithm is proposed.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

Université de Lille
CHU Lille

Collections :

• METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694

Submission date :

2023-11-15T06:58:02Z
2024-01-30T09:43:29Z