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Expanding the indication of endoscopic papillectomy for T1a ampullary carcinoma
Author(s) -
Yamamoto Kenjiro,
Itoi Takao,
Sofuni Atsushi,
Tsuchiya Takayoshi,
Tanaka Reina,
Tonozuka Ryosuke,
Honjo Mitsuyoshi,
Mukai Shuntaro,
Fujita Mitsuru,
Asai Yasutsugu,
Matsunami Yukitoshi,
Kurosawa Takashi,
Yamaguchi Hiroshi,
Nagakawa Yuichi
Publication year - 2019
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1111/den.13265
Subject(s) - medicine , lymphovascular invasion , gastroenterology , cancer , metastasis
Background and Aim Endoscopic papillectomy ( EP ) has been attempted not only for benign lesions but also for early ampullary carcinoma ( AC ). However, there is still no sufficient evidence or consensus regarding the effectiveness of EP for early AC . Herein, we evaluated the expanding indication of EP for early AC . Methods Between May 1999 and December 2016, 177 patients were diagnosed with ampullary tumor before undergoing EP , and their clinical and histopathological data were analyzed retrospectively. Results There were 27 Tis‐T1a AC patients and four T1b AC patients who underwent EP . Mean tumor size was 14.1 mm for Tis‐T1a AC and 17.0 mm for T1b AC . For the histological grade, 50% (2/4) of T1b AC were moderately differentiated, whereas 96.3% (26/27) of Tis‐T1a AC were well differentiated and papillary. For lymphovascular invasion, one (25%) occurred in T1b AC but none occurred in Tis‐T1a AC . There was no AC recurrence from the date of EP until a maximum of 5 years (Tis‐T1a: mean period 48.5 months [5–60]; T1b: mean period 26.5 months [3–60]). Conclusions Endoscopic papillectomy is useful and reliable for the curative treatment of T1a AC . Large‐scale prospective studies with long‐term follow up are needed.