1651P - Comparison of surgical outcome and prognostic factors between pancreaticobiliary and intestinal types of periampullary adenocarcinoma following pancreaticoduodenectomy

Background

The exact origin and associated prognosis of periampullary adenocarcinoma might be challenging to determine, especially in bulky tumours, due to the destruction of normal periampullary anatomy and the extension of the tumour beyond a single periampullary structure. Periampullary carcinomas are typically divided into pancreatobiliary and intestinal types according to histological differentiation. The aim of this study was to determine the prognostic value of this histological differentiation by comparing various clinic-pathological prognostic factors and surgical outcome in periampullary carcinoma cases that underwent pancreaticoduodenectomy.

Methods

From May 2018 to April 2021, 60 consecutive cases of periampullary carcinoma who underwent pancreaticoduodenectomy were included in this study. Cases were divided into two groups: pancreatobiliary and intestinal types. Various clinical and histopathological prognostic variables were analysed, and the association of these variables with pancreatobiliary and intestinal variants of periampullary carcinoma was determined using Chi-square and Fischer’s exact tests.

Results

20 cases were included in the pancreatobiliary group, and 40 cases were included in the intestinal group. These groups were comparable in terms of age, sex, nutritional status, and bilirubin levels. Pancreatobiliary type was more frequently associated with nodal disease (p<0.01), lymphovascular invasion (p<0.01) and perineural invasion (p=0.018). Post-operative morbidity was significantly higher in the pancreatobiliary group (p=0.043). Table: 1651P

Conclusions

After pancreaticoduodenectomy, periampullary cancer of the pancreatobiliary type is linked to worse post-operative outcome and unfavourable histopathological prognostic markers. Therefore, after surgery, these cases should follow management algorithms with aggressive adjuvant therapy protocols.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.