Surgical Outcomes and Prognostic Factors for Ampulla of Vater Cancer

Abstract

Background and Aims: the prognosis for patients with ampulla of Vater cancer is better than other periampullary cancers. the aim of the present study is to determine the clinicopathologic factors predictive of survival and recurrence in patients with ampulla of Vater cancer.Material and Methods: from 1991 to 2008, we identified and reviewed 78 patients with ampulla of Vater cancer retrospectively. clinicopathologic factors possibly influencing survival and recurrence were statistically analyzed.Results: pancreaticoduodenectomy was performed in 68 patients and 2 patients underwent transduodenal ampullectomy. Hospital mortality was 2.6%. the 5-year survival rates following resection were 59.9%. univariate analysis for overall survival revealed that total bilirubin greater than 5mg/dl, ulcerative tumors, differentiation, and pancreatic invasion were significant prognostic factors. recurrence occurred in 31 patients. univariate analysis for disease-free survival revealed that total bilirubin greater than 5mg/ dl, preoperative biliary drainage, tumor differentiation, and stage were statistically significant. multivariate analysis revealed that tumor differentiation was an independent prognostic factor for recurrence. the presence of lymph node metastasis did not affect overall survival significantly in this study. However, two or more metastatic lymph nodes significantly affect disease-free survival.Conclusions: pancreaticoduodenectomy is a safe surgical procedure with acceptable long-term survival for ampulla of Vater cancer. pancreaticoduodenectomy with lymph node dissection might control lymph node spread and enhance survival outcome.

Surgical Treatment of Ampullary Adenocarcinoma – Single Center Experience and a Review of Literature

“…6), and due to this evidence, PD seems to be superior in longterm survival against TSA [14]. Moreover, in our group of performed PD, we observed a metastatic lymph node involvement in high number, specifically in 70%.…”

“…However, most authors coincide that positive lymph node involvement seems to be the most important factor for longterm survival in patients after resection for ampullary adenocarcinoma [3,14,19,22].…”

“…Ampullary adenocarcinoma has a bet ter longterm prognosis when com pared to pancreatic adeno carcinoma or extrahepatic bile duct carcinoma [13]. Choi et al [14] reported a 59.9% over all 5year survival rate after R0 resection. The reason seems to be due a higher resecta bility rate and less aggressive tumor cha racteristics comparison to other periam pullary cancer [3,15,16].…”

The Diagnostic Value of Pyruvate Kinase Isoenzyme Type M2 for Biliary Tract Carcinoma. A Systematic Review and Meta-Analysis

“…Exceptionally, the 5-year survival rates of AC patients were 43.3-61.0% [6][7][8] for early symptoms and curative surgery stages [9]. Despite a slight downward trend worldwide over the past few decades according to National Cancer Institute (SEER Program; http://seer.cancer.gov/) and global cancer statics [10], the prevalence of GBC is constantly rising and is a substantial cause of mortality in some regions, for example, in Shanghai, China [10,11].…”

Prognostic Factors and Adjuvant Treatments for Surgically Treated Cancers of the Biliary Tract: A Multicentre Study of the Anatolian Society of Medical Oncology (ASMO)

“…The main parameters are stage, perineural and vascular invasion, resection margin (Choi et al, 2009;Choi, et al, 2011;Fisher et al, 2012;Sriputtha et al, 2013;Pattanathien et al, 2013). In addition, several scoring systems were identified to predict prognosis (Berardi et al, 2013).…”