Pancreatobiliary versus intestinal histologic type of differentiation is an independent prognostic factor in resected periampullary adenocarcinoma

Abstract

Background: Resectable adenocarcinomas in the pancreatic head, by definition "periampullary", originate from ampullary, duodenal, biliary, or ductal pancreatic epithelium. Typically, periampullary adenocarcinomas have either intestinal or pancreatobiliary type of differentiation, and the type of differentiation might be prognostically more important than the anatomic site of origin. The aim of the study was to determine whether the histologic type of differentiation is an independent prognostic factor in periampullary adenocarcinoma, and whether tumour origin predicts the prognosis in pancreatobiliary type carcinomas independently of resection margin involvement, tumour size, nodal involvement, perineural and vascular infiltration, and degree of differentiation.

Reclassification of tumour origin in resected periampullary adenocarcinomas reveals underestimation of distal bile duct cancer

“…A high lymph node yield could also in some reports result from resections involving extended lymphadenectomy 165 . The median number of lymph nodes evaluated in the present study is thus representative of a medium-volume tertiary referral institution.…”

Molecular signatures of mRNAs and miRNAs as prognostic biomarkers in pancreatobiliary and intestinal types of periampullary adenocarcinomas

“…Adenocarcinomas of all the four anatomical sites are classified according to the histological appearance and most of them fall into either pancreatobiliary (P) or intestinal (I) type (Albores-Saavedra et al, 2007;Westgaard et al, 2008). The adenocarcinomas with origin in the ampulla, at the intersection of the pancreas, the common bile duct and the duodenum, are those that typically can exhibit either an intestinal or pancreatobiliary appearance or a mixture of the two.…”

“…Adjuvant chemotherapy on PAs has proven to have an additional effect of survival compared to surgery alone (Neoptolemos et al, 2012, Oettle et al, 2007. Interestingly, there is evidence that histological subtype may be of even stronger prognostic impact than the anatomical site of origin (Westgaard et al, 2008). The patients suffering from adenocarcinoma of intestinal type do better than patients with adenocarcinoma of pancreatobiliary type (Albores-Saavedra et al, 2007, Westgaard et al, 2008.…”

“…Interestingly, there is evidence that histological subtype may be of even stronger prognostic impact than the anatomical site of origin (Westgaard et al, 2008). The patients suffering from adenocarcinoma of intestinal type do better than patients with adenocarcinoma of pancreatobiliary type (Albores-Saavedra et al, 2007, Westgaard et al, 2008. Patients with tumors of the same histological subtype, but from different anatomical site of origin, have similar overall survival (Westgaard et al, 2013).…”

Immunophenotyping and oncogene amplifications in tumors of the papilla of Vater

“…According to the classification by the Armed Forces Institute of Pathology (AFIP), an intestinal type (IT), resembling carcinomas of intestinal origin, and a pancreatico-biliary type (PBT), resembling carcinomas of the extrahepatic bile ducts or the pancreas, are the most common subtypes and account for 70-95% of cases [5,6,[16][17][18][19][20][21]. Other subtypes include an intestinal-mucinous type (IMT), an invasive papillary type (IPT), a poorly differentiated adenocarcinoma (G3AC), and several rather uncommon entities [18].…”