{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T05:41:27Z","timestamp":1787809287509,"version":"build-2784847793"},"reference-count":26,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2021,3,7]],"date-time":"2021-03-07T00:00:00Z","timestamp":1615075200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Gastro and Hepatol"],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Aim<\/jats:title><jats:p>While recent evidences support endoscopic resection as curative in ampullary tumors with high\u2010grade intraepithelial neoplasia, only small case series have reported endoscopic management of early\u2010stage ampullary cancer; thus, radical surgery remains the only accepted treatment modality. We evaluated the long\u2010term outcomes of early ampullary adenocarcinoma administered endoscopic management.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively reviewed electronic medical records of 715 patients undergoing endoscopic papillectomy (EP) in a single tertiary medical center in Korea in 2004\u20132016. We included patients incidentally diagnosed with early\u2010stage adenocarcinoma (Tis and T1a, American Joint Committee on Cancer 8th edition) after EP and with &gt;2\u00a0years of follow\u2010up data and analyzed their demographics, histopathologic data, and clinical outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 70 total patients in the EP\u2010alone (<jats:italic>n<\/jats:italic>\u00a0=\u00a042) and subsequent surgery (<jats:italic>n<\/jats:italic>\u00a0=\u00a028) groups, we observed no significant differences in demographics or tumor size (2.0\u00a0\u00b1\u00a00.6 <jats:italic>vs<\/jats:italic> 1.9\u00a0\u00b1\u00a00.5\u00a0cm, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.532), histologic grade (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.077), tumor extent (<jats:italic>P<\/jats:italic>\u00a0=\u00a01.000), lymphovascular invasion (2.4% <jats:italic>vs<\/jats:italic> 10.7%, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.344), or complete resection rates (57.1% <jats:italic>vs<\/jats:italic> 57.1%, <jats:italic>P<\/jats:italic>\u00a0=\u00a01.000) between groups. Adenocarcinoma lesions were larger in the subsequent surgery group (0.7\u00a0\u00b1\u00a00.5 <jats:italic>vs<\/jats:italic> 1.1\u00a0\u00b1\u00a00.7\u00a0cm, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.002). The EP\u2010alone group received more additional ablative treatment (42.9% <jats:italic>vs<\/jats:italic> 14.3%, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.024). The 5\u2010year disease\u2010free and cancer\u2010free survival rates were 79.1% <jats:italic>vs<\/jats:italic> 87.4% (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.111) and 93.5% <jats:italic>versus<\/jats:italic> 87.4% (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.726), respectively, and did not differ significantly between groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Endoscopic papillectomy followed by endoscopic surveillance showed long\u2010term outcomes comparable with surgical resection for early ampullary cancer and maybe curable alternative to surgery for incidentally found early\u2010stage ampullary cancer, especially in patients unfit for or refusing radical surgery.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jgh.15462","type":"journal-article","created":{"date-parts":[[2021,2,19]],"date-time":"2021-02-19T07:18:55Z","timestamp":1613719135000},"page":"2315-2323","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Long\u2010term outcomes of endoscopic papillectomy for early\u2010stage cancer in duodenal ampullary adenoma: Comparison to surgical treatment"],"prefix":"10.1111","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0454-7527","authenticated-orcid":false,"given":"Jun Seong","family":"Hwang","sequence":"first","affiliation":[{"name":"Department of Internal Medicine Inje University College of Medicine, Haeundae Paik Hospital  Busan South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hoonsub","family":"So","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology University of Ulsan College of Medicine, Asan Medical Center  Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6084-0138","authenticated-orcid":false,"given":"Dongwook","family":"Oh","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology University of Ulsan College of Medicine, Asan Medical Center  Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tae Jun","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology University of Ulsan College of Medicine, Asan Medical Center  Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Do Hyun","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology University of Ulsan College of Medicine, Asan Medical Center  Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dong\u2010Wan","family":"Seo","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology University of Ulsan College of Medicine, Asan Medical Center  Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sung Koo","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology University of Ulsan College of Medicine, Asan Medical Center  Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Myung\u2010Hwan","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology University of Ulsan College of Medicine, Asan Medical Center  Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seung\u2010Mo","family":"Hong","sequence":"additional","affiliation":[{"name":"Department of Pathology University of Ulsan College of Medicine, Asan Medical Center  Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jungho","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Pathology University of Ulsan College of Medicine, Asan Medical Center  Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sang Soo","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology University of Ulsan College of Medicine, Asan Medical Center  Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,3,7]]},"reference":[{"key":"e_1_2_5_2_1","first-page":"1163","article-title":"Neoplasia of the ampulla of Vater. 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