Endoscopic papillectomy for ampullary lesions in patients with familial adenomatous polyposis compared with sporadic lesions: a propensity score-matched cohort.
Journal
Endoscopy
ISSN: 1438-8812
Titre abrégé: Endoscopy
Pays: Germany
ID NLM: 0215166
Informations de publication
Date de publication:
08 2023
08 2023
Historique:
medline:
31
7
2023
pubmed:
7
2
2023
entrez:
6
2
2023
Statut:
ppublish
Résumé
Familial adenomatous polyposis (FAP) is a rare inherited syndrome that predisposes the patient to cancer. Treatment of FAP-related ampullary lesions is challenging and the role of endoscopic papillectomy has not been elucidated. We retrospectively analyzed the outcomes of endoscopic papillectomy in matched cohorts of FAP-related and sporadic ampullary lesions (SALs). This retrospective multicenter study included 1422 endoscopic papillectomy procedures. Propensity score matching including age, sex, comorbidity, histologic subtype, and size was performed. Main outcomes were complete resection (R0), technical success, complications, and recurrence. Propensity score matching identified 202 patients (101 FAP, 101 SAL) with comparable baseline characteristics. FAP patients were mainly asymptomatic (79.2 % [95 %CI 71.2-87.3] vs. 46.5 % [95 %CI 36.6-56.4]); Endoscopic papillectomy was safe and effective in FAP-related ampullary lesions. Criteria for endoscopic resection of ampullary lesions can be extended to FAP patients. FAP patients have a lifetime risk of relapse even after complete resection, and require long-time surveillance.
Sections du résumé
BACKGROUND
Familial adenomatous polyposis (FAP) is a rare inherited syndrome that predisposes the patient to cancer. Treatment of FAP-related ampullary lesions is challenging and the role of endoscopic papillectomy has not been elucidated. We retrospectively analyzed the outcomes of endoscopic papillectomy in matched cohorts of FAP-related and sporadic ampullary lesions (SALs).
METHODS
This retrospective multicenter study included 1422 endoscopic papillectomy procedures. Propensity score matching including age, sex, comorbidity, histologic subtype, and size was performed. Main outcomes were complete resection (R0), technical success, complications, and recurrence.
RESULTS
Propensity score matching identified 202 patients (101 FAP, 101 SAL) with comparable baseline characteristics. FAP patients were mainly asymptomatic (79.2 % [95 %CI 71.2-87.3] vs. 46.5 % [95 %CI 36.6-56.4]);
CONCLUSIONS
Endoscopic papillectomy was safe and effective in FAP-related ampullary lesions. Criteria for endoscopic resection of ampullary lesions can be extended to FAP patients. FAP patients have a lifetime risk of relapse even after complete resection, and require long-time surveillance.
Types de publication
Multicenter Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
709-718Investigateurs
Francesco Auriemma
(F)
Aiste Gulla
(A)
Elias Karam
(E)
Marc Giovannini
(M)
Jean-Philippe Ratone
(JP)
Uwe Will
(U)
Rita Saadeh
(R)
Marco J Bruno
(MJ)
Pierre Deprez
(P)
Urban Arnelo
(U)
Erik Haraldsson
(E)
Alexander Waldthaler
(A)
Galen Leung
(G)
Mark A Schattner
(MA)
William R Jarnagin
(WR)
Tiegong Wang
(T)
Jean M Fabre
(JM)
Georg Kähler
(G)
Alberto Mariani
(A)
Piera Zaccari
(P)
Giulio Belfiori
(G)
Massimo Falconi
(M)
Stefano Partelli
(S)
Alessandro Repici
(A)
Andrea Anderloni
(A)
Johanna Laukkarinen
(J)
Albrecht Hoffmeister
(A)
Jonas Rosendahl
(J)
Brigitte Schumacher
(B)
Louise Barbier
(L)
Dominik Heling
(D)
Steffen Muehldorfer
(S)
Stéphanie Truant
(S)
Karel Caca
(K)
Marcel Tantau
(M)
Katrin Salzmann
(K)
Patrice David
(P)
Arthur Schmidt
(A)
Tullio Piardi
(T)
J Matthias Löhr
(JM)
Johan Gagniére
(J)
Bogdan P Miutescu
(BP)
Arthur Berger
(A)
Peter Schemmer
(P)
Christian Heise
(C)
Vasile Sandru
(V)
Reea Ahola
(R)
Mario Dinis-Ribeiro
(M)
Tiago Cúrdia Gonçalves
(TC)
Dörte Wichmann
(D)
Informations de copyright
Thieme. All rights reserved.
Déclaration de conflit d'intérêts
M. Hollenbach has received honoraria for lectures and expert panel from FUJIFILM. E. Wedi and A. Schmidt has received honoraria for lectures and research support from Ovesco AG.