Search Our Scientific Publications & Authors

Front Med (Lausanne) 2020 6;7:152. Epub 2020 May 6.

Department of Digestive, Hepatobiliary and Endocrine Surgery, Paris Descartes University, Cochin Hospital, Paris, France.

Lesions of the Ampulla of Vater are a rare condition and represent <10% of peri-ampullary neoplasms. Nevertheless, ampullary adenomas have the potential for malignant transformation to ampullary carcinomas by an adenoma-to-carcinoma sequence. Thus, adequate patient selection and complete resection (R0) of non-invasive ampullary lesions either by endoscopic papillectomy (EP), surgical ampullectomy (SA), or pancreaticoduodenectomy (PD) is essential. Read More

Expert Rev Gastroenterol Hepatol 2020 May 22:1-10. Epub 2020 May 22.

Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan.

: Endoscopic papillectomy (EP) has been established as a useful endoscopic therapy by the efforts of many pancreatobiliary endoscopists and is presently accepted as a reliable alternative therapy to surgery in patients with ampullary adenoma. Moreover, there have been numerous advancements in EP techniques in recent years. Various approaches and attempts toward expanding the indications of endoscopic resection have been reported. Read More

J Med Imaging Radiat Oncol 2020 May 6. Epub 2020 May 6.

Department of Radiology, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia.

Introduction: To examine the hepatic volume changes post-selective internal radiation therapy with Y microspheres. This technique has been demonstrated to be a suitable alternative to portal vein embolisation to induce hypertrophy of the future liver remnant (FLR) in patients with malignant disease of the liver preoperatively. The role of both techniques is to decrease postoperative morbidity and increase the numbers of patients eligible for surgical resection. Read More

Eur Radiol 2020 Apr 28. Epub 2020 Apr 28.

Nanfang PET Center, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Avenue North, Guangzhou, 510515, Guangdong Province, China.

Objectives: Diagnosing ampullary and duodenal papillary carcinomas (ADPCs) is challenging. In the present study, we investigated the application value of F-fluorodeoxyglucose positron emission tomography/computed tomography (F-FDG PET/CT) in the preoperative evaluation of these tumours.

Methods: F-FDG PET/CT images of 58 patients with ADPC and 28 patients with benign disease were retrospectively analysed. Read More

HPB (Oxford) 2020 Apr 18. Epub 2020 Apr 18.

Department of Radiation Oncology, Stanford University, 875 Blake Wilbur Drive, Stanford, CA, 94305, USA. Electronic address:

Background: Signet ring cell carcinoma (SRCC) of the ampulla of Vater is poorly understood, with approximately 22 reported cases. Our study sought to create a comprehensive review of cases in the United States.

Methods: We used the Surveillance, Epidemiology, and End Results Program to collect all cases of ampullary adenocarcinoma diagnosed between 2010 and 2015. Read More

J Gastrointest Surg 2020 Apr 6. Epub 2020 Apr 6.

The Department of Pancreato-Biliary Surgery, The First Affiliated Hospital, Sun Yat-sen University, 58 Zhongshan 2nd Rd, Guangzhou, 510080, China.

Background: The minimum number of lymph nodes (LNs) that should be resected for accurate nodal staging in patients with ampullary carcinoma (AC) remains controversial. This study aimed to establish a nodal staging score (NSS) to evaluate whether a pathological node-negative AC patient is indeed free of a nodal disease.

Methods: A total of 2539 AC patients with stages I-III were retrieved from the Surveillance, Epidemiology and End Result database (design cohort [DC], n = 2382) and First Affiliated Hospital of Sun Yat-sen University (validation cohort [VC], n = 157). Read More

Niger J Surg 2020 Jan-Jun;26(1):48-52. Epub 2020 Feb 10.

Department of Surgery, Government Medical College and Hospital, Chandigarh, India.

Background: Postoperative pancreatic fistula (POPF) or leak from pancreaticojejunostomy (PJ) is one of the most common complications after pancreaticoduodenectomy (PD), with an incidence of 5%-30%. Various techniques have been advocated to bring down the incidence of POPF, but there is still none that can be called the "gold standard". Peng's binding PJ (BPJ) was proposed as a good method of performing PJ with low fistula rates; we present our results with BPJ. Read More

Gan To Kagaku Ryoho 2019 Dec;46(13):2357-2359

Dept. of Surgery, Kansai Rosai Hospital.

We report a case of liver metastases of ampullary carcinoma that achieved clinical complete response after gemcitabine plus cisplatin(GC)combination chemotherapy. A 69-year-old man with obstructive jaundice was diagnosed with ampullary carcinoma and underwent laparoscopic pancreaticoduodenectomy. Postoperative histopathological examination revealed pT3aN0M0, Stage ⅡA adenocarcinoma of the papilla of Vater. Read More

Gastroenterol Res Pract 2020 6;2020:2080351. Epub 2020 Jan 6.

Department of Pathology, Woodland Hospital, Dhankheti, East Khasi Hills, Shillong, Meghalaya 793003, India.

Tumors involving the ampulla could be arising primarily in the ampulla or extending from the adjacent. When a neoplasm is centered primarily in the ampulla with or without periampullary mucosal involvement, it is considered a primary ampullary carcinoma. These tumors generally have a better prognosis than duodenal and pancreaticobiliary neoplasms secondarily involving the ampulla. Read More

J Can Assoc Gastroenterol 2020 Feb 18;3(1):17-25. Epub 2019 Mar 18.

The Center for Therapeutic Endoscopy and Endoscopic Oncology, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.

Background: The management of ampullary lesions has shifted from surgical approach to endoscopic resection. Previous reports were limited by small numbers of patients and short follow-up. The aim of this study is to describe short- and long-term outcomes in a large cohort of patients undergoing endoscopic ampullectomy. Read More

Clin J Gastroenterol 2020 Jan 24. Epub 2020 Jan 24.

Department of Gastroenterology, Faculty of Medicine, Yamagata University, 2-2-2 Iidanishi, Yamagata, Yamagata, 990-8595, Japan.

Signet-ring cell carcinoma of the ampulla of Vater is a rare tumor. A 74-year-old woman presented with epigastric pain and was diagnosed with cholangitis. Her liver enzyme levels were elevated. Read More

J Gastrointest Surg 2020 Jan 2. Epub 2020 Jan 2.

Unit of Gastroenterology and Digestive Endoscopy, Azienda USL-IRCCS di Reggio Emilia, 42123, Reggio Emilia, Italy.

Background: Ampullary adenomas are rare and potentially malignant. Surgery was the standard treatment but endoscopic papillectomy (EP) is a possible alternative.

Aim: We retrospectively evaluated the principal clinical outcomes of EP in all patients referred to our unit also dividing sporadic ampullary adenoma (SAA) from familial adenomatous polyposis (FAP)-associated adenomas. Read More

J Surg Oncol 2020 Mar 26;121(3):518-523. Epub 2019 Dec 26.

Department of Pancreato-Biliary Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.

Background: The accuracy of the current staging system for predicting the overall survival (OS) of patients with ampullary carcinoma (AC) is still unsatisfactory, especially in node-negative (N0) patients. We aimed at establishing a nomogram to accurately predict OS in N0 AC.

Methods: This study enrolled 697 N0 AC patients from the Surveillance, Epidemiology, and End Results database (design cohort [DC], n = 697) and the First Affiliated Hospital of Sun Yat-sen University (validation cohort [VC], n = 112), who underwent surgical resection. Read More

Nagoya J Med Sci 2019 Nov;81(4):679-685

Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.

A 71-year-old woman with dysphagia was diagnosed with thoracic esophageal squamous cell carcinoma by endoscopic biopsy at another hospital. She had previously undergone partial breast excision with axillary lymph node dissection for right breast cancer eleven years earlier and subtotal stomach-preserving pancreatoduodenectomy with Child's reconstruction for ampullary cancer ten years earlier. Gastrointestinal endoscopy showed a stricture due to a bulging submucosal tumor in the mid-thoracic esophagus. Read More

J Surg Oncol 2019 Dec 15. Epub 2019 Dec 15.

University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.

Background And Objectives: Ampullary adenocarcinoma (AA) is classified by immunohistochemical (IHC) subtypes into intestinal (IN), pancreatobiliary (PB), and ambiguous (AM). The impact of adjuvant therapy on IHC subtype and disease stage is unclear. We examined the effect of adjuvant chemotherapy regimen on survival of ampullary cancers by IHC subtype and disease stage. Read More

Anticancer Res 2019 Dec;39(12):6923-6929

First Department of Surgery, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan.

Background/aim: The platelet-to-lymphocyte ratio (PLR) has recently been suggested as a new predictor of the prognosis in several carcinoma types. However, the clinical impact remains controversial in patients with ampullary carcinoma. Thus, the aim of this study was to investigate other useful biomarkers for identifying poor prognosis in patients with ampullary carcinoma. Read More

BMJ Case Rep 2019 Nov 10;12(11). Epub 2019 Nov 10.

Department of Ophthalmology, James Paget University Hospitals NHS Foundation Trust, Great Yarmouth, UK.

A 64-year-old woman presented with bilateral visual loss with shimmering photopsias as the only clinical manifestation of an occult pancreatic ampullary adenocarcinoma causing duct dilatation. Abnormal electroretinograms led to suspicion of cancer-associated retinopathy (CAR), and CT of the abdomen showed an underlying pancreatic malignancy, detected with subclinical liver function tests following diagnosis of CAR. Biopsy showed a T2N0M0 ampullary adenocarcinoma. Read More

Surg Case Rep 2019 Nov 8;5(1):176. Epub 2019 Nov 8.

Department of General Surgery, Toyohashi Municipal Hospital, 50 Hachiken-nishi, Aotake-cho, Toyohashi, Aichi, 441-8570, Japan.

Background: Clinical evidence of intraductal dissemination through the pancreatic duct has been rare. We herein describe a case of ampullary carcinoma that disseminated in the remnant pancreas through the pancreatic duct.

Case Presentation: A 68-year-old woman underwent SSPPD for ampullary carcinoma. Read More

Medicine (Baltimore) 2019 Nov;98(44):e17711

Center for Liver and Pancreatobiliary Cancer, National Cancer Center, Goyang-Si, Gyeonggi-Do.

We aimed to identify the factors for very early recurrence (within 6 months) of ampullary cancer following curative resection and to compare the immunohistochemical expression rate of various antibodies between the 2 main histologic subtypes of ampullary adenocarcinoma.In this retrospective study, the postoperative outcomes and clinicopathologic factors for very early recurrence that occurred in 14 of 93 patients who underwent pancreaticoduodenectomy (PD) for ampullary adenocarcinoma between January 2002 and August 2014 were analyzed. Thereafter, we identified the factors associated with very early recurrence following surgery. Read More

Endosc Int Open 2019 Nov 23;7(11):E1515-E1521. Epub 2019 Oct 23.

Department of Gastroenterology, Fujita Health University School of Medicine, Toyoake, Japan.

Endoscopic diagnosis of superficial non-ampullary duodenal epithelial tumors (SNADETs) has not been established. Probe-based confocal laser endomicroscopy (pCLE: Cellvizio) provides real-time endomicroscopic analysis. We developed and validated a new pCLE classification of SNADET based on abnormal findings. Read More

Surg Endosc 2019 Oct 23. Epub 2019 Oct 23.

Pancreatic Surgery Unit, Humanitas Clinical and Research Center - IRCCS, Alessandro Manzoni 56, Rozzano, 20089, Milan, Italy.

Background: Trans-duodenal ampullectomy (TDA) is a surgical option for the treatment of selected ampullary neoplasms. The aim of this study was to evaluate our experience with TDA for the treatment of ampullary neoplasms, focusing on indications, technical aspects, and short- and long-term outcomes.

Methods: All TDAs for ampullary neoplasms performed between January 2010 and December 2018 at our institution were retrospectively evaluated. Read More

Int J Cancer 2020 May 11;146(10):2913-2922. Epub 2019 Nov 11.

Department of Oncology, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark.

Hyaluronan (HA) and collagen are highly expressed in pancreatic cancer (PC) stroma. HA and collagen accumulation increase tumor interstitial fluid pressure, compromising blood flow and drug penetration. The aim of this biomarker study was to determine the clinical utility of serum HA and the propeptide of type III collagen (PRO-C3) in patients with PC. Read More

Pathol Oncol Res 2019 Oct 22. Epub 2019 Oct 22.

Arkadi M Rywlin Department of Pathology and Laboratory Medicine, Mount Sinai Medical Center, 4300 Alton road, Suite 2400, Miami Beach, FL, 33140, USA.

The classification of ampullary adenocarcinoma into intestinal and pancreatobiliary sub-types has been found to be important in predicting prognosis and determining therapeutic strategy. Due to considerable inter-observer variability in sub-typing based solely on morphology, higher frequency of poorly differentiated cancers and low incidence of the disease, the histomorphologic classification of ampullary adenocarcinoma remains one of the grey zones in surgical pathology. Pan-IN is a well recognized precursor to pancreatic adenocarcinoma. Read More

J Gastroenterol Hepatol 2020 May 6;35(5):821-826. Epub 2019 Nov 6.

Division of Endoscopy, Shizuoka Cancer Center, Shizuoka, Japan.

Background And Aim: It is imperative to distinguish superficial non-ampullary duodenal carcinomas (NADCs) between intramucosal and submucosal invasive carcinoma for treatment selection. The aim of this study was to evaluate the clinicopathological differences of intramucosal and submucosal carcinoma.

Methods: This was a retrospective, single-center study comprising 134 patients with 137 superficial NADCs during May 2005 and March 2018. Read More

Int J Surg Pathol 2020 May 15;28(3):236-244. Epub 2019 Oct 15.

Koç University, Istanbul, Turkey.

In the ampulla of Vater, carcinomas with "diffuse-infiltrative"/"signet ring cell" morphology, designated as "poorly cohesive carcinoma" (PCC) in the WHO classification, are very rare and poorly characterized. Nine cases with a classical PCC morphology constituting >50% of the tumor were identified. Mean age was 64. Read More

Oncol Rev 2019 Jul 10;13(2):440. Epub 2019 Sep 10.

Hematology-Oncology, University of Alabama at Birmingham Hospital, Birmingham, AL, USA.

Ampullary Carcinoma arises from a histologically heterogeneous region where three different epithelia converge. Even though Ampullary Carcinoma has a superior prognosis compared to pancreatic and biliary ductal neoplasms, at least half of the patients turn up at an advanced stage that limits the treatment prospects. In addition to surgery for early-stage disease, several studies have shown that chemoradiotherapy confers additional benefits in the management of Ampullary Carcinoma. Read More

Med Sci Monit 2019 Sep 30;25:7332-7341. Epub 2019 Sep 30.

Department of Pancreatic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China (mainland).

BACKGROUND Intra-ampullary papillary-tubular neoplasm (IAPN) is recognized as a precancerous lesion with a great tendency to evolve into pancreatic cancer. The Surveillance, Epidemiology, and End Results (SEER) database is now large enough to study unusual cancers. Based on pathologic and epidemiologic characteristics of IAPN available in SEER, important clinicopathological correlations can be made. Read More

Sci Rep 2019 09 25;9(1):13836. Epub 2019 Sep 25.

Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland.

Thermal ablation has proven beneficial for hepatocellular carcinoma and possibly for colorectal liver metastases, but data is lacking for other liver metastases. Computer-assisted navigation can increase ablation efficacy and broaden its indications. We present our experience with percutaneous stereotactic image-guided microwave ablation (SMWA) for non-colorectal liver metastases (NCRLM), in form of a retrospective study including all SMWA for NCRLM from 2015 to 2017. Read More

Dig Endosc 2020 Mar 31;32(3):417-424. Epub 2019 Oct 31.

Division of Research and Development for Minimally Invasive Treatment, Cancer Center, Keio University School of Medicine, Tokyo, Japan.

There are no reports on detailed endoscopic diagnosis of superficial non-ampullary duodenal epithelial tumors (SNADET) except for relatively small case series. Herein, we conducted a prospective observational study to investigate the relationship between endoscopic findings and histopathological diagnosis of SNADET. A total of 163 SNADET diagnosed using magnified endoscopic examination with image-enhanced endoscopy (IEE-ME) were prospectively registered in this study. Read More

Sci Rep 2019 09 3;9(1):12676. Epub 2019 Sep 3.

Department of Visceral, Thoracic and Vascular Surgery, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Germany.

Ampullary cancer represents approximately 6% of the malignant periampullary tumors. An early occurrence of symptoms leads to a 5-year survival rate after curative surgery of 30 to 67%. In addition to the tumor stage, the immunohistological subtypes appear to be important for postoperative prognosis. Read More

Turk J Gastroenterol 2019 Aug;30(8):714-721

Department of Interventional Radiology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China.

Background/aims: For distal malignant biliary obstruction (MBO), a percutaneous metal stent is usually inserted by the transpapillary method. However, stent-related complications and recurrent biliary obstruction following transpapillary stent placement are concerns, and survival analysis of patients with distal MBO has rarely been done.

Materials And Methods: From January 2012 to March 2016, 104 patients underwent transpapillary uncovered metal stent placement for distal MBO at our institution. Read More

Purinergic Signal 2019 09 10;15(3):367-374. Epub 2019 Aug 10.

Department of Histopathology, Shaikh Zayd Hospital, Lahore, Punjab, 54000, Pakistan.

The primary malignancy of liver, known as hepatocellular carcinoma (HCC), comprises 9% of all hepatobiliary carcinomas. A steady rise has also been observed in adenocarcinoma (ADC) of the liver and ampullary carcinoma (AMC), ascending to 0.5% of gastrointestinal malignancies. Read More

Clin J Gastroenterol 2020 Apr 10;13(2):214-218. Epub 2019 Aug 10.

Division of Endoscopy, Shizuoka Cancer Center, 1007 Shimonagakubo Nagaizumi-cho, Sunto-gun, Shizuoka, Japan.

Primary gastrointestinal follicular lymphoma is a rare disease. Follicular lymphoma does not cause any typical symptoms, although it usually shows the presence of multiple white granules on endoscopy. Few patients with follicular lymphoma present with the initial symptom of jaundice, which is usually associated with follicular lymphomas located in the papilla of Vater. Read More

World J Surg Oncol 2019 Aug 9;17(1):140. Epub 2019 Aug 9.

Department of Gastroenterological Surgery, Graduate School of Medicine, Yokohama City University, 3-9, Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan.

Background: Expression of High-Mobility Group Box 1 (HMGB1), a multifunctional protein involved in DNA function as well as cell proliferation, inflammation, and the immune response, has been reported to be prognostic in several types of malignancies. However, the prognostic value of HMGB1 in ampullary cancer has not been studied.

Methods: Patients with adenocarcinoma of the ampulla of Vater who underwent R0 resection with pancreaticoduodenectomy between 2001 and 2011 were included in the present multi-institutional study. Read More

Oncotarget 2019 Jul 16;10(44):4509-4510. Epub 2019 Jul 16.

Sorbonne Paris - Cité, Paris Descartes University, Department of Gastroenterology and GI Oncology, Georges Pompidou European Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France; Centre de Recherche UMR-S 1147, Médecine Personnalisée, Pharmacogénomique, Optimisation Thérapeutique, Institut National de la Santé et de la Recherche Médicale, Paris, France.

Infect Drug Resist 2019 11;12:1513-1527. Epub 2019 Jun 11.

Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB, Canada.

The gut microbiota play an essential role in protecting the host against pathogenic microorganisms by modulating immunity and regulating metabolic processes. In response to environmental factors, microbes can hugely alter their metabolism. These factors can substantially impact the host and have potential pathologic implications. Read More

Clin J Gastroenterol 2020 Feb 24;13(1):37-45. Epub 2019 Jul 24.

Department of Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan.

Mixed adenoneuroendocrine carcinoma (MANEC) is defined as a tumor composed of both adenocarcinoma and neuroendocrine components. Here, we report the case of a 75-year-old woman with ampullary MANEC. She visited a physician with the chief complaint of dark urine and was diagnosed with advanced jaundice. Read More

Pathol Int 2019 Jul 21;69(7):398-406. Epub 2019 Jul 21.

Division of Pathology, Shizuoka Cancer Center, Shizuoka, Japan.

The tumorigenesis of non-ampullary duodenal epithelial tumors (NADETs) might be different between the oral and anal sides of Vater's papilla. We conducted an immunohistological review to elucidate the clinicopathological features according to the tumor location and phenotypic classification. A review of an institutional database identified 121 patients with 125 superficial NADETs. Read More

Intern Med 2019 Nov 10;58(21):3087-3092. Epub 2019 Jul 10.

Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Japan.

A 70-year-old man was admitted to our hospital due to elevated levels of hepatobiliary and pancreatic enzymes. Computed tomography showed contrast-enhanced mucosal hypertrophy from the duodenal papilla to the distal bile duct. Endoscopic examinations revealed a laterally spreading granular tumor and ampullary swelling. Read More

Diagn Cytopathol 2019 Oct 5;47(10):1059-1062. Epub 2019 Jul 5.

Department of Pathology and Laboratory Medicine, Weill Cornell Medicine-New York Presbyterian Hospital, New York, New York.

Small intestinal adenomas are uncommon. Majority of these occur in the region of the ampulla of Vater. Adenomas of the ampulla can be further subdivided into two types-intestinal and pancreatobiliary. Read More

J Clin Pathol 2019 Nov 29;72(11):762-770. Epub 2019 Jun 29.

Department of Pathology, Odense University Hospital, Odense, Denmark

Aims: Knowledge regarding the genetic features of ampullary carcinoma (AC) in European patients is limited. The utility of tumour markers for the establishment of a malignant diagnosis in biopsies from the ampullary region has not been fully elucidated. We aimed to describe the clinical, pathological, immunohistochemical (IHC) and genetic features of a Danish series of surgically resected ACs. Read More

Hepatobiliary Surg Nutr 2019 Jun;8(3):201-210

Department of Surgery, Charité Campus Mitte and Charité Campus Virchow Klinikum, Charité-Universitätsmedizin Berlin, Berlin, Germany.

Background: While the long-term survival rate among patients with pancreatic and periampullary carcinomas remains low, it can be influenced by various factors. The purpose of this retrospective study was to investigate the effects of body mass index (BMI) on postoperative complications and patient survival after pancreatic resections for underlying malignancy over a 20-year observation period.

Methods: We analyzed 1,384 patients, 918 patients with pancreatic ductal adenocarcinoma (PDAC) (66. Read More

Pathologica 2019 Mar;111(1):24-30

Departments of Histopathology, Surrey Pathology Services, Frimley Park and Royal Surrey County Hospitals, Guildford, UK.

Background: Adenocarcinoma involving the pancreas shows differences in prognostic parameters including resection margin status depending on subtype.

Aim: To assess the reported incidence of each type and the rate of R1 resection using detailed histopathological examination protocol.

Methods: All pancreaticoduodenectomies between June 2011 and June 2013 at our institute were analysed. Read More

Gan To Kagaku Ryoho 2019 May;46(5):937-939

Dept. of Digestive Surgery, Kawaguchi Municipal Medical Center.

A 19-year-old woman with general fatigue who initially consulted a local hospital was referred to us for further examination of jaundice. Contrast-enhanced CT revealed apparent dilatation of the bile duct. Gastrointestinal endoscopy exhibited a tumor of the papilla of Vater(adenocarcinoma, tub2). Read More

J Oncol 2019 2;2019:3293509. Epub 2019 May 2.

Division of Medical Oncology, KU Cancer Center, The University of Kansas Health System, USA.

Introduction: Ampullary cancers represent a subset of periampullary cancers, comprising only 0.2% all gastrointestinal cancers. Localized disease is primarily managed by a surgical intervention, called pancreaticoduodenectomy (PD), followed in many cases by the administration of adjuvant chemotherapy (CT) or chemoradiation therapy (CRT). Read More

Hum Pathol 2019 09 6;91:26-35. Epub 2019 Jun 6.

Department of Diagnostic Pathology, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan; Institute of Liver Studies, King's College Hospital & King's College London, London SE5 9RS, United Kingdom. Electronic address:

We recently experienced cases of pancreatobiliary-type intraductal papillary mucinous neoplasms (PB-IPMNs) with imaging features resembling pancreatic ductal adenocarcinomas (PDACs), and histologic appearance of purely pancreatobiliary morphology and highly distorted papillary growth, which led to the present study aiming to systematically investigate PB-IPMNs in comparison with PDACs. Surgical cases of PB-IPMNs (n = 31) and PDACs (n = 24) were examined. PB-IPMNs were classified into monotypic tumors (n = 12; 39%) consisting of entirely high-grade pancreatobiliary-type neoplastic cells and polytypic cases (n = 19; 61%) associated with components of low-grade dysplasia and/or other histologic types (eg, gastric, intestinal, or oncocytic types). Read More

JAMA Surg 2019 Aug;154(8):706-714

Department of Surgery, University of Tennessee Health Science Center, Memphis.

Importance: Ampullary adenocarcinoma is a rare malignant neoplasm that arises within the duodenal ampullary complex. The role of adjuvant therapy (AT) in the treatment of ampullary adenocarcinoma has not been clearly defined.

Objective: To determine if long-term survival after curative-intent resection of ampullary adenocarcinoma may be improved by selection of patients for AT directed by histologic subtype. Read More

Lancet Gastroenterol Hepatol 2019 08 17;4(8):611-621. Epub 2019 May 17.

Department of Medical Oncology, Kyorin University Faculty of Medicine, Mitaka, Tokyo, Japan.

Background: This study aimed to assess the safety and tolerability of the immune checkpoint inhibitor nivolumab, as monotherapy or combined with chemotherapy, in Japanese patients with biliary tract cancer.

Methods: This multicentre, open-label, phase 1 trial was done at four cancer centres in Japan. Eligible patients were aged 20-79 years, had biliary tract adenocarcinoma (intrahepatic bile duct cancer, extrahepatic bile duct cancer, gallbladder cancer, or ampullary cancer), Eastern Cooperative Oncology Group performance status 0 or 1, adequate hepatic, renal, and haematological function, and tumour tissue samples for PD-L1 expression analysis. Read More

HPB (Oxford) 2019 11 2;21(11):1535-1540. Epub 2019 May 2.

Department of Medical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, People's Republic of China. Electronic address:

Background: The role of adjuvant radiotherapy for resected ampullary carcinoma (AC) remains controversial. The aim of this study was to assess the effect of adjuvant radiotherapy on survival in patients who underwent resection for AC.

Methods: The Surveillance, Epidemiology and End Results (SEER) database was used to identify patients diagnosed with AC from 2004 to 2012. Read More