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Limited Resection Versus Pancreaticoduodenectomy for Duodenal Gastrointestinal Stromal Tumors? Enucleation Interferes in the Debate: A European Multicenter Retrospective Cohort Study

  • Pancreatic Tumors
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

The optimal surgical procedure for duodenal gastrointestinal stromal tumors (D-GISTs) remains poorly defined. Pancreaticoduodenectomy (PD) allows for a wide resection but is associated with a high morbidity rate.

Objectives

The aim of this study was to compare the short- and long-term outcomes of PD versus limited resection (LR) for D-GISTs and to evaluate the role of tumor enucleation (EN).

Methods

In this retrospective European multicenter cohort study, 100 patients who underwent resection for D-GIST between 2001 and 2013 were compared between PD (n = 19) and LR (n = 81). LR included segmental duodenectomy (n = 47), wedge resection (n = 21), or EN (n = 13). The primary objective was to evaluate disease-free survival (DFS) between the groups, while the secondary objectives were to analyze the overall morbidity and mortality, radicality of resection, and 5-year overall survival (OS) and recurrence rates between groups. Furthermore, the short- and long-term outcomes of EN were evaluated.

Results

Baseline characteristics were comparable between the PD and LR groups, except for a more frequent D2 tumor location in the PD group (68.3% vs. 29.6%; p = 0.016). Postoperative morbidity was higher after PD (68.4% vs. 23.5%; p < 0.001). OS (p = 0.70) and DFS (p = 0.64) were comparable after adjustment for D2 location and adjuvant therapy rate. EN was performed more in American Society of Anesthesiologists (ASA) stage III/IV patients with tumors < 5 cm and was associated with a 5-year OS rate of 84.6%, without any disease recurrences.

Conclusions

For D-GISTs, LR should be the procedure of choice due to lower morbidity and similar oncological outcomes compared with PD. In selected patients, EN appears to be associated with equivalent short- and long-term outcomes. Based on these results, a surgical treatment algorithm is proposed.

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Acknowledgements

Participating Investigators (Collected Data) Department of Digestive Surgery, Amiens Picardie University Hospital, France: Francois Browet, MD; Charles Sabbagh, MD, PhD; Jean-Marc Regimbeau, MD. Department of Digestive Surgery, Angers, France: Emilie Lermite, MD PhD; Antoine Hamy, MD, PhD. Department of Digestive Surgery, Blois, France: Kevin Kraft, MD. Department of Digestive Surgery, Hôpital Avicennes, Bobigny, France: Richard Douard, MD, PhD; Philippe Wind, MD. Department of Digestive Surgery, Haut-Levêque University Hospital, Bordeaux, France: Hélène Gersen-Cherdieu, MD; Denis Collet, MD; Magalie Cabau, MD. Department of Digestive Surgery, Hôpital Saint André, Bordeaux, France: Christophe Laurent, MD PhD; Eric Rullier, MD. General Surgery, Department of Experimental and Clinical Sciences, University of Brescia, Brescia, Italy: Arianna Coniglio, MD. Department of Digestive Surgery, Cavale Blanche University Hospital, Brest, France: Charles-Henry Gancel, MD; Bogdan Badic, MD. Department of Digestive Surgery, Briey Hospital, France: Gilbert Ouedraogo, MD. Department of Digestive Surgery, Coltea Hospital, Bucharest, Romania: Mircea Beuran, MD. Department of Digestive Surgery, Polyclinique Synergia, Carpentras, France: Aude Brams, MD, PhD; Marc Kanor, MD; Christophe Louis, MD; Yves Russier, MD. Department of Digestive Surgery, Beaujon University Hospital, Clichy, France: Yves Panis, MD, PhD; Léon Maggiori, MD, PhD. Department of Digestive Surgery, Louis Mourier University Hospital, Colombes, France: Camille Caille, MD; Géraud Tuyeras, MD; Simon Msika, MD. Department of Digestive Surgery, Dijon, France: Luigi De Magistris, MD; T. Perrin, MD; Patrick Rat, MD; Pablo Ortega Deballon, MD, PhD. Department of Digestive Surgery, Douai Hospital, France: Philippe Meignie, MD. Department of Digestive Surgery, Clinique de la Ligne Bleue, Epinal, France: Jean François Bronner, MD ; Jacques Moline, MD. Department of Digestive Surgery, Forez Hospital, Feurs, France: Claude Mondersert, MD. Department of Digestive Surgery, Furiani Polyclinic, France: André Caamano, MD. Department of Digestive Surgery, Grenoble, France: Catherine Arvieux, MD, PhD; Jean-Luc Faucheron, MD, PhD; Christian Letoublon, MD; Antoine Guillaud, MD. Department of Digestive Surgery, Saint Odile Clinic, Haguenau, France: Ségolène Lardenois, MD; Jean-Michel Nuss, MD. Department of Digestive Surgery, Fondation Hôtel-Dieu Hospital, Le Creusot, France: Patrick Chevillotte, MD. Department of Oncological and Digestive Surgery, Lille University Hospital, France: Edouard Vinatier, MD; Williams Tessier, MD. Department of Digestive and Endocrine Surgery, Lille University Hospital, Lille, France: Robert Caiazzo, MD, PhD; François Pattou, MD, PhD. Department of Digestive Surgery, Lille, Oscar Lambret Center, Lille, France: Nicolas Lamande, MD; Mehrdad Jafari, MD; Gauthier Decanter, MD. Department of Digestive Surgery, Limoges, France: François Paraf, MD. Department of Digestive Surgery, Lyon-Sud Hospital, Lyon, France: Mohamed Alyami, MD; Delphine Vaudoyer, MD; Guillaume Passot, MD, PhD; Olivier Glehen, MD, PhD. Department of Digestive Surgery, Croix-Rousse Hospital, Lyon, France: Hassan Demian, MD; Christian Ducerf, MD; Jean-Yves Mabrut, MD, PhD. Department of Digestive Surgery, Centre Leon Berard, Lyon, France: Marc Rivoire, MD, PhD. Department of Digestive Surgery, Infirmerie Protestante, Lyon, France: Vincent Garbit, MD; Thierry Leclercq, MD; Jean Loire, MD; Olivier Raspado, MD. Department of Digestive Surgery, la Timone Hospital, Marseilles, France: Rémy Le Huu Nho, MD; Mehdi Ouaissi, MD, PhD; Igor Sieleznef, MD, PhD; Bernard Sastre, MD. Department of Digestive Surgery, Saint Joseph Hospital, Marseilles, France: Bernard Pol, MD; Manuela Campanile, MD. Department of Digestive Surgery, la Conception Hospital, Marseilles, France: Sami Hamed, MD; Jean Hardwigsen, PD, PhD; Yves-Patrice Le Treut, MD. Department of Digestive Surgery, Mende, France: Gérard Carbonnel, MD. Department of Digestive Surgery, Legouest Hospital, Metz, France: Charlotte de Saint Roman, MD; M. Tréot, MD; Philippe Sockeel, MD. Department of Digestive Surgery, Saint François Clinic, Montluçon, France: Ghislain Tourreau, MD; Vasileios Baltzopoulos, MD. Department of Digestive Surgery, Montpellier, Val D'Aurelle Hospital, France: Anne Mourregot, MD; Philippe Rouanet, MD. Department of Digestive Surgery, Nancy University Hospital, France: L. Bresler, MD, PHD. Department of Digestive Surgery, Nantes University Hospital, Nantes, France: P. Senellart, MD; Guillaume Meurette, MD, PhD; Paul Antoine Lehur, MD; Nicolas Regenet, MD. Department of Digestive Surgery, Nice, France: Vincent Casanova, MD; Anne Sophie Schneck, MD; Antonio Ianelli, MD, PhD; Jean Gugenheim, MD. Department of Digestive Surgery, Pitié-Salpétrière University Hospital, Paris, France: Mehdi Karoui, MD, PhD; Jean Christophe Vaillant, MD; Jean Baptise Bachet, MD, PhD; Laurent Hannoun, MD. Department of Digestive and Visceral Surgery, Pitié-Salpétrière University Hospital, Paris, France: Renato Lupinacci, MD; Francois Menegaux, MD, PhD; Christophe Tresallet, MD, PhD. Department of Digestive Surgery, Kremlin-Bicètre Hospital, France: Antoine Brouquet, MD, PhD; Stéphane Benoist, MD, PhD; Christophe Penna, MD, PhD. Department of Digestive Surgery, Saint-Antoine Hospital, Paris, France: Pierre Balladur, MD, PhD; Yann Parc, MD, PhD; François Paye, MD, PhD; Najim Chafai, MD; Emmanuel Tiret, MD. Department of Digestive Surgery, Saint Louis Hospital, Paris, France: Pierre Cattan, MD, PhD; Emile Sarfati, MD; Leonor Benhaim, MD. Department of Digestive Surgery, Tenon Hospital, Paris, France: F. Sista, MD; Sidney Houry, MD. Department of Digestive Surgery, Institut Curie, Paris, France: Pascale Mariani, MD. Department of Digestive Surgery, Institut Mutualiste Montsouris, Paris, France: Béatrice Ullua Severino, MD; Brice Gayet, MD; Thierry Perniceni, MD. Department of Digestive Surgery, Poitiers, France: Jean-Pierre Richer, MD; Jean Pierre Faure, MD; Jean Louis Kraimps, MD. Department of Digestive Surgery, Reims, France: Sophie Deguelte-Lardiere, MD; Olivier Bouche, MD, PhD; Reza Kianmanesch, MD, PhD. Department of Digestive Surgery, Rennes, France: Charles Le Clec'h, MD; Laurent Sulpice, MD; Bernard Meunier, MD; Karim Boudjema, MD. Department of Digestive Surgery, Rouen, France: Emmanuel Huet, MD; Michel Scotte, MD, PhD; Francis Michot, MD. Department of Digestive Surgery, Saint-Etienne, France: Thomas Sole, MD; Clément Costanza, MD; Charlotte Vermesch, MD; Santina Bruno, MD; Jack Porcheron, MD. Department of Digestive Surgery, New Civil Hospital, Strasbourg, France: M. Raharimanantsoa, MD; Patrick Pessaux, MD, PhD; Silvana Perretta, MD, PhD; Didier Mutter, MD. Department of Digestive Surgery, Strasbourg, CHU, Hôpital de Hautepierre, Strasbourg, France: H. Mercoli, MD; A. Klipfel, MD; E.H. Triki, MD; B. Romain, MD; S. Dragomir, MD; N. Chilintseva, MD; J.C. Olliern, MD; Serge Rohr, MD. Department of Digestive Surgery, Foch Hospital, Suresnes, France: Alexandre Rault, MD. Department of Digestive Surgery, Purpan Hospital, Toulouse, France: Charles Henri Julio, MD; Mael Chalret du Rieu, MD; Nicolas Carrere, MD, PhD; Bernard Pradère, MD. Department of Digestive Surgery, Tours, France: Perrine Senellart, MD; Baudoin Thébault, MD. Department of Digestive Surgery, Trieste, Italy: Nicolo De Manzini, MD. Department of Digestive Surgery, Valence, France: Christophe Henry, MD. Department of Digestive Surgery, Gustave-Roussy Institute, Villejuif, France: Sylvie Bonvalot, MD

Funding

No sources of funding were used to assist in the preparation of this study.

Author information

Author notes

  1. Clément Dubois and Frederiek Nuytens contributed equally to this work.

Authors and Affiliations

  1. Department of Digestive and Oncological Surgery, University Lille, Claude Huriez University Hospital, CHU de Lille, Lille, France

    Clément Dubois MD, Frederiek Nuytens MD, Maxime Warlaumont MD & Guillaume Piessen MD, PhD

  2. University Lille, CHU Lille, ULR 2694 – METRICS : Évaluation des technologies de santé et des pratiques médicales, Lille, France

    Hélène Behal & Alain Duhamel PhD

  3. Department of Digestive Surgery, Haut Lévêque University Hospital, Bordeaux, France

    Caroline Gronnier MD, PhD & Quentin Denost MD, PhD

  4. Department of Digestive Surgery, Pitié-Salpêtrière University Hospital, Paris, France

    Gilles Manceau MD, PhD

  5. Department of Surgery, Institut Gustave Roussy, Villejuif, France

    Charles Honoré MD, PhD

  6. Department of Digestive Surgery, Dijon University Hospital, Dijon, France

    Olivier Facy MD, PhD

  7. Department of Digestive Surgery, Charles Nicolle University Hospital, Rouen, France

    Jean-Jacques Tuech MD, PhD

  8. General Surgery, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy

    Guido Tiberio MD

  9. Department of Digestive Surgery, Hautepierre University Hospital, Strasbourg, France

    Cécile Brigand MD, PhD

  10. Department of Digestive Surgery, Brest University Hospital, Brest, France

    Jean-Pierre Bail MD

  11. Department of Digestive Surgery, Tours University Hospital, Tours, France

    Ephrem Salame MD

  12. Department of Digestive Surgery, Pontchailloux University Hospital, Rennes, France

    Bernard Meunier MD, PhD

  13. Department of Digestive Surgery, Sorbonne Université, AP-HP, Hôpital Saint Antoine, Paris, France

    Jérémie H. Lefevre MD, PhD

  14. Department of Digestive Surgery, Limoges University Hospital, Limoges, France

    Muriel Mathonnet MD, PhD

  15. Department of Digestive Surgery, Clinique Claude Bernard RAMSAY, Ermont, France

    Mohamed Sbai Idrissi MD

  16. Department of Pathology, Lille University Hospital, Lille, France

    Florence Renaud MD, PhD

  17. University Lille, CNRS, Inserm, CHU Lille, UMR9020-U1277 – CANTHER – Cancer Heterogeneity, Plasticity and Resistance to Therapies, Lille, France

    Florence Renaud MD, PhD & Guillaume Piessen MD, PhD

  18. Department of Digestive Surgery, Amiens Picardie University Hospital, Amiens, France

    Francois Browet, Charles Sabbagh & Jean-Marc Regimbeau

  19. Department of Digestive Surgery, Angers, France

    Emilie Lermite & Antoine Hamy

  20. Department of Digestive Surgery, Blois, France

    Kevin Kraft

  21. Department of Digestive Surgery, Hôpital Avicennes, Bobigny, France

    Richard Douard & Philippe Wind

  22. Department of Digestive Surgery, Haut-Levêque University Hospital, Bordeaux, France

    Hélène Gersen-Cherdieu, Denis Collet & Magalie Cabau

  23. Department of Digestive Surgery, Hôpital Saint André, Bordeaux, France

    Christophe Laurent & Eric Rullier

  24. General Surgery, Department of Experimental and Clinical Sciences, University of Brescia, Brescia, Italy

    Arianna Coniglio

  25. Department of Digestive Surgery, Cavale Blanche University Hospital, Brest, France

    Charles-Henry Gancel & Bogdan Badic

  26. Department of Digestive Surgery, Briey Hospital, Briey, France

    Gilbert Ouedraogo

  27. Department of Digestive Surgery, Coltea Hospital, Bucharest, Romania

    Mircea Beuran

  28. Department of Digestive Surgery, Polyclinique Synergia, Carpentras, France

    Aude Brams, Marc Kanor, Christophe Louis & Yves Russier

  29. Department of Digestive Surgery, Beaujon University Hospital, Clichy, France

    Yves Panis & Léon Maggiori

  30. Department of Digestive Surgery, Louis Mourier University Hospital, Colombes, France

    Camille Caille, Géraud Tuyeras & Simon Msika

  31. Department of Digestive Surgery, Dijon, France

    Luigi De Magistris, T. Perrin, Patrick Rat & Pablo Ortega Deballon

  32. Department of Digestive Surgery, Douai Hospital, France

    Philippe Meignie

  33. Department of Digestive Surgery, Clinique de la Ligne Bleue, Epinal, France

    Jean François Bronner & Jacques Moline

  34. Department of Digestive Surgery, Forez Hospital, Feurs, France

    Claude Mondersert

  35. Department of Digestive Surgery, Furiani Polyclinic, Furiani, France

    André Caamano

  36. Department of Digestive Surgery, Grenoble, France

    Catherine Arvieux, Jean-Luc Faucheron, Christian Letoublon & Antoine Guillaud

  37. Department of Digestive Surgery, Saint Odile Clinic, Haguenau, France

    Ségolène Lardenois & Jean-Michel Nuss

  38. Department of Digestive Surgery, Fondation Hôtel-Dieu Hospital, Le Creusot, France

    Patrick Chevillotte

  39. Department of Oncological and Digestive Surgery, Lille University Hospital, Lille, France

    Edouard Vinatier & Williams Tessier

  40. Department of Digestive and Endocrine Surgery, Lille University Hospital, Lille, France

    Robert Caiazzo & François Pattou

  41. Department of Digestive Surgery, Lille, Oscar Lambret Center, Lille, France

    Nicolas Lamande, Mehrdad Jafari & Gauthier Decanter

  42. Department of Digestive Surgery, Limoges, France

    François Paraf

  43. Department of Digestive Surgery, Lyon-Sud Hospital, Lyon, France

    Mohamed Alyami, Delphine Vaudoyer, Guillaume Passot & Olivier Glehen

  44. Department of Digestive Surgery, Croix-Rousse Hospital, Lyon, France

    Hassan Demian, Christian Ducerf & Jean-Yves Mabrut

  45. Department of Digestive Surgery, Centre Leon Berard, Lyon, France

    Marc Rivoire

  46. Department of Digestive Surgery, Infirmerie Protestante, Lyon, France

    Vincent Garbit, Thierry Leclercq, Jean Loire & Olivier Raspado

  47. Department of Digestive Surgery, la Timone Hospital, Marseilles, France

    Rémy Le Huu Nho, Mehdi Ouaissi, Igor Sieleznef & Bernard Sastre

  48. Department of Digestive Surgery, Saint Joseph Hospital, Marseilles, France

    Bernard Pol & Manuela Campanile

  49. Department of Digestive Surgery, la Conception Hospital, Marseilles, France

    Sami Hamed, Jean Hardwigsen & Yves-Patrice Le Treut

  50. Department of Digestive Surgery, Mende, France

    Gérard Carbonnel

  51. Department of Digestive Surgery, Legouest Hospital, Metz, France

    Charlotte de Saint Roman, M. Tréot & Philippe Sockeel

  52. Department of Digestive Surgery, Saint François Clinic, Montluçon, France

    Ghislain Tourreau & Vasileios Baltzopoulos

  53. Department of Digestive Surgery, Val D’Aurelle Hospital, Montpellier, France

    Anne Mourregot & Philippe Rouanet

  54. Department of Digestive Surgery, Nancy University Hospital, Nancy, France

    L. Bresler

  55. Department of Digestive Surgery, Nantes University Hospital, Nantes, France

    P. Senellart, Guillaume Meurette, Paul Antoine Lehur & Nicolas Regenet

  56. Department of Digestive Surgery, Nice, France

    Vincent Casanova, Anne Sophie Schneck, Antonio Ianelli & Jean Gugenheim

  57. Department of Digestive Surgery, Pitié-Salpétrière University Hospital, Paris, France

    Mehdi Karoui, Jean Christophe Vaillant, Jean Baptise Bachet & Laurent Hannoun

  58. Department of Digestive and Visceral Surgery, Pitié-Salpétrière University Hospital, Paris, France

    Renato Lupinacci, Francois Menegaux & Christophe Tresallet

  59. Department of Digestive Surgery, Kremlin-Bicètre Hospital, Le Kremlin-Bicêtre, France

    Antoine Brouquet, Stéphane Benoist & Christophe Penna

  60. Department of Digestive Surgery, Saint-Antoine Hospital, Paris, France

    Pierre Balladur, Yann Parc, François Paye, Najim Chafai & Emmanuel Tiret

  61. Department of Digestive Surgery, Saint Louis Hospital, Paris, France

    Pierre Cattan, Emile Sarfati & Leonor Benhaim

  62. Department of Digestive Surgery, Tenon Hospital, Paris, France

    F. Sista & Sidney Houry

  63. Department of Digestive Surgery, Institut Curie, Paris, France

    Pascale Mariani

  64. Department of Digestive Surgery, Institut Mutualiste Montsouris, Paris, France

    Béatrice Ullua Severino, Brice Gayet & Thierry Perniceni

  65. Department of Digestive Surgery, Poitiers, France

    Jean-Pierre Richer, Jean Pierre Faure & Jean Louis Kraimps

  66. Department of Digestive Surgery, Reims, France

    Sophie Deguelte-Lardiere, Olivier Bouche & Reza Kianmanesch

  67. Department of Digestive Surgery, Rennes, France

    Charles Le Clec’h, Laurent Sulpice, Bernard Meunier & Karim Boudjema

  68. Department of Digestive Surgery, Rouen, France

    Emmanuel Huet, Michel Scotte & Francis Michot

  69. Department of Digestive Surgery, Saint-Etienne, France

    Thomas Sole, Clément Costanza, Charlotte Vermesch, Santina Bruno & Jack Porcheron

  70. Department of Digestive Surgery, New Civil Hospital, Strasbourg, France

    M. Raharimanantsoa, Patrick Pessaux, Silvana Perretta & Didier Mutter

  71. Department of Digestive Surgery, Strasbourg, CHU, Hôpital de Hautepierre, Strasbourg, France

    H. Mercoli, A. Klipfel, E. H. Triki, B. Romain, S. Dragomir, N. Chilintseva, J. C. Olliern & Serge Rohr

  72. Department of Digestive Surgery, Foch Hospital, Suresnes, France

    Alexandre Rault

  73. Department of Digestive Surgery, Purpan Hospital, Toulouse, France

    Charles Henri Julio, Mael Chalret du Rieu, Nicolas Carrere & Bernard Pradère

  74. Department of Digestive Surgery, Tours, France

    Perrine Senellart & Baudoin Thébault

  75. Department of Digestive Surgery, Trieste, Italy

    Nicolo De Manzini

  76. Department of Digestive Surgery, Valence, France

    Christophe Henry

  77. Department of Digestive Surgery, Gustave-Roussy Institute, Villejuif, France

    Sylvie Bonvalot

Authors
  1. Clément Dubois MD
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  2. Frederiek Nuytens MD
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  3. Hélène Behal
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  4. Caroline Gronnier MD, PhD
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  5. Gilles Manceau MD, PhD
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  6. Maxime Warlaumont MD
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  7. Alain Duhamel PhD
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  8. Quentin Denost MD, PhD
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  9. Charles Honoré MD, PhD
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  10. Olivier Facy MD, PhD
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  11. Jean-Jacques Tuech MD, PhD
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  12. Guido Tiberio MD
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  13. Cécile Brigand MD, PhD
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  14. Jean-Pierre Bail MD
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  15. Ephrem Salame MD
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  16. Bernard Meunier MD, PhD
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  17. Jérémie H. Lefevre MD, PhD
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  18. Muriel Mathonnet MD, PhD
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  19. Mohamed Sbai Idrissi MD
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  20. Florence Renaud MD, PhD
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  21. Guillaume Piessen MD, PhD
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Consortia

the AFC and FREGAT Working Group

  • Francois Browet
  • , Charles Sabbagh
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  • , Williams Tessier
  • , Robert Caiazzo
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  • , Guillaume Passot
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  • , Manuela Campanile
  • , Sami Hamed
  • , Jean Hardwigsen
  • , Yves-Patrice Le Treut
  • , Gérard Carbonnel
  • , Charlotte de Saint Roman
  • , M. Tréot
  • , Philippe Sockeel
  • , Ghislain Tourreau
  • , Vasileios Baltzopoulos
  • , Anne Mourregot
  • , Philippe Rouanet
  • , L. Bresler
  • , P. Senellart
  • , Guillaume Meurette
  • , Paul Antoine Lehur
  • , Nicolas Regenet
  • , Vincent Casanova
  • , Anne Sophie Schneck
  • , Antonio Ianelli
  • , Jean Gugenheim
  • , Mehdi Karoui
  • , Jean Christophe Vaillant
  • , Jean Baptise Bachet
  • , Laurent Hannoun
  • , Renato Lupinacci
  • , Francois Menegaux
  • , Christophe Tresallet
  • , Antoine Brouquet
  • , Stéphane Benoist
  • , Christophe Penna
  • , Pierre Balladur
  • , Yann Parc
  • , François Paye
  • , Najim Chafai
  • , Emmanuel Tiret
  • , Pierre Cattan
  • , Emile Sarfati
  • , Leonor Benhaim
  • , F. Sista
  • , Sidney Houry
  • , Pascale Mariani
  • , Béatrice Ullua Severino
  • , Brice Gayet
  • , Thierry Perniceni
  • , Jean-Pierre Richer
  • , Jean Pierre Faure
  • , Jean Louis Kraimps
  • , Sophie Deguelte-Lardiere
  • , Olivier Bouche
  • , Reza Kianmanesch
  • , Charles Le Clec’h
  • , Laurent Sulpice
  • , Bernard Meunier
  • , Karim Boudjema
  • , Emmanuel Huet
  • , Michel Scotte
  • , Francis Michot
  • , Thomas Sole
  • , Clément Costanza
  • , Charlotte Vermesch
  • , Santina Bruno
  • , Jack Porcheron
  • , M. Raharimanantsoa
  • , Patrick Pessaux
  • , Silvana Perretta
  • , Didier Mutter
  • , H. Mercoli
  • , A. Klipfel
  • , E. H. Triki
  • , B. Romain
  • , S. Dragomir
  • , N. Chilintseva
  • , J. C. Olliern
  • , Serge Rohr
  • , Alexandre Rault
  • , Charles Henri Julio
  • , Mael Chalret du Rieu
  • , Nicolas Carrere
  • , Bernard Pradère
  • , Perrine Senellart
  • , Baudoin Thébault
  • , Nicolo De Manzini
  • , Christophe Henry
  •  & Sylvie Bonvalot

Contributions

All authors meet the International Committee of Medical Journal Editors (ICMJE) authorship criteria. Clément Dubois: Analysis and interpretation of data, drafting the manuscript, final approval. Frederiek Nuytens: Analysis and interpretation of data, drafting the manuscript, final approval. Hélène Behal: Analysis and interpretation of data, vouching for the data, revision of the manuscript, final approval. Caroline Gronnier: Acquisition of data, revision of the manuscript, final approval. Gilles Manceau: Acquisition of data, revision of the manuscript, final approval. Maxime Warlaumont: Acquisition of data, revision of the manuscript, final approval. Alain Duhamel: Analysis and interpretation of data, vouching for the data, revision of the manuscript, final approval. Quentin Denost MD: Acquisition of data, revision of the manuscript, final approval. Charles Honoré MD: Acquisition of data, revision of the manuscript, final approval. Olivier Facy: Acquisition of data, revision of the manuscript, final approval. Jean-Jacques Tuech: Acquisition of data, revision of the manuscript, final approval. Guido Tiberio: Acquisition of data, revision of the manuscript, final approval. Cécile Brigand: Acquisition of data, revision of the manuscript, final approval. Jean-Pierre Bail: Acquisition of data, revision of the manuscript, final approval. Ephrem Salame: Acquisition of data, revision of the manuscript, final approval. Bernard Meunier: Acquisition of data, revision of the manuscript, final approval. Jérémie H. Lefevre: Acquisition of data, revision of the manuscript, final approval. Muriel Mathonnet: Acquisition of data, revision of the manuscript, final approval. Mohamed Sbai Idrissi: Acquisition of data, revision of the manuscript, final approval. Florence Renaud: Acquisition of data, revision of the manuscript, final approval. Guillaume Piessen: Design of the study, decision on publication of the paper, analysis and interpretation of data, revision of the manuscript, final approval.

Corresponding author

Correspondence to Frederiek Nuytens MD.

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Disclosure

Clément Dubois, Frederiek Nuytens, Hélène Behal, Caroline Gronnier, Gilles Manceau, Maxime Warlaumont, Alain Duhamel, Quentin Denost, Charles Honoré, Olivier Facy, Jean-Jacques Tuech, Guido Tiberio, Cécile Brigand, Jean-Pierre Bail, Ephrem Salame, Bernard Meunier, Jérémie H. Lefevre, Muriel Mathonnet, Mohamed Sbai Idrissi, Florence Renaud, Guillaume Piessen have no conflicts of interest to declare.

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Dubois, C., Nuytens, F., Behal, H. et al. Limited Resection Versus Pancreaticoduodenectomy for Duodenal Gastrointestinal Stromal Tumors? Enucleation Interferes in the Debate: A European Multicenter Retrospective Cohort Study. Ann Surg Oncol 28, 6294–6306 (2021). https://doi.org/10.1245/s10434-021-09862-7

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