Surgical strategy for carcinoma of the papilla of vater on the basis of lymphatic spread and mode of recurrence

Kayahara, Masato; Nagakawa, Takukazu; Ohta, Tetsuo; Kitagawa, Hirohisa; Miyazaki, Itsuo

doi:10.1016/s0039-6060(97)90048-9

Cited by 86 publications

(108 citation statements)

References 15 publications

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“…However, the significance of para-aortic lymph node dissection remains unclear (27). Lymph node metastasis was a statistically significant factor for recurrence (17,28). In our study, patients with two or more metastatic lymph nodes demonstrated significantly poorer disease-free survival than 0 or 1 metastatic lymph nodes.…”

Section: Discussionmentioning

confidence: 52%

Surgical Outcomes and Prognostic Factors for Ampulla of Vater Cancer

et al. 2011

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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.

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Section: Discussionmentioning

confidence: 52%

Surgical Outcomes and Prognostic Factors for Ampulla of Vater Cancer

et al. 2011

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“…In our study we found no statistically significant differences regarding the length of hospitalization, morbidity and mortality rate, disease-free and overall survival for both standard and radical lymphadenectomies, those values being consistent with the literature, as described above. Nodal involvement is the most important independent prognostic factor in patients with adenocarcinoma of the papilla [15][16][17][18][19][20][21] , followed by the depth of tumor infiltration [15][16][17]22 , negative margins 16,23 , histological grade 22 and the need for blood transfusion 18,22 . O' Connell et al 24 described an overall survival for patients with positive and negative lymph nodes of 21.9% and 54.1%, respectively.…”

Section: Results Results Results Resultsmentioning

confidence: 99%

“…Many studies based on lymphatic mapping demonstrated that the pancreatic-duodenal lymph nodes (13 and 17) are the first lymph nodes to be affected by metastatic disease and the other groups are much less frequently envolvidas 19,20,26 . The incidence of lymph node involvement by groups in our population was similar to that described in the literature and the presence of lymph node metastases in other nodal groups without involvement of the pancreato-duodenal group was not observed, suggesting a sequence in the progression of nodal disease.…”

Section: Results Results Results Resultsmentioning

confidence: 99%

Estudo da linfadenectomia radical comparada à linfadenectomia standard no tratamento cirúrgico do adenocarcinoma da papila de Vater

Albagli¹,

Carvalho²,

Mali³

et al. 2010

Rev. Col. Bras. Cir.

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OBJETIVO: avaliar a morbidade e a mortalidade cirúrgica em pacientes submetidos a gastroduodenopancreatectomia (GDP) com linfadenectomia padrão e radical para adenocarcinoma de papila, analisando os fatores prognósticos com relação à sobrevida global e livre de doença. MÉTODOS: foram analisados retrospectivamente no período de 1999 a 2007, no Serviço de Cirurgia Abdômino-Pélvica do INCa-RJ, 50 casos de GDP para adenocarcinoma da papila duodenal divididos em dois grupos de acordo com a linfadenectomia (grupo A: linfadenectomia padrão e grupo B: linfadenectomia radical). RESULTADOS: A mediana de idade foi semelhante nos dois grupos, assim como a distribuição entre os sexos. Na comparação entre as linfadenectomias somente o número de linfonodos ressecados (grupo A: 12,3 e grupo B: 26,5) e o tempo operatório (grupo A: 421 e grupo B: 474) foram significativamente diferentes. Não ocorreram diferenças estatisticamente significativas nos dois grupos com relação a morbi-mortalidade operatória e tempo de internação. A sobrevida livre de doença (grupo A: 35 meses e grupo B: 51 meses) e sobrevida global (grupo A: 38 meses e grupo B: 53 meses) foi maior no grupo da linfadenectomia radical, porém não foram significantes estatisticamente. CONCLUSÃO: no presente estudo não ocorreram casos de linfonodos metastáticos para outros grupos nodais sem o acometimento linfonodal das cadeias pancreato-duodenais (13 e 17), sugerindo um padrão de disseminação linfonodal. Apesar da linfadenectomia radical apresentar taxas de sobrevida livre de doença e sobrevida global maiores esses dados não foram significativos estatisticamente. Novos estudos devem ser realizados para avaliar o real papel da linfadenectomia radical no adenocarcinoma da papila duodenal.

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“…Metastasis is a complex process, involving local invasion, inward and outward infiltration of tumor cells, and decreased host immunological responses [1][2][3][4] . In carcinoma of papilla of Vater, lymph node metastases are present at the time of diagnosis in 31%-52% of the patients and by radical tumor resection, 5 year-survival rates of reached 21%-61% [3] .…”

Section: Introductionmentioning

confidence: 99%

“…In carcinoma of papilla of Vater, lymph node metastases are present at the time of diagnosis in 31%-52% of the patients and by radical tumor resection, 5 year-survival rates of reached 21%-61% [3] . In contrast to cancers of the papilla of Vater, cancer of pancreas has a dismal prognosis.…”

Section: Introductionmentioning

confidence: 99%

KAI1 gene is differently expressed in papillary and pancreatic cancer: Influence on metastasis

Guo¹

2000

WJG

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AIM To compare KAI1 in cancer of papilla of Vater and pancreas to evaluate whether there are differences in biologic behavior which might account for prognosis. METHODS We compared the expression in 24 papillay and 29 pancreatic cancers using Northern blot analysis, immunochemical assay and in situ hybridization, and investigated whether early diagnosis or molecular differences predict the outcome in these tumor entities. RESULTS By Northern blot analysis there is no statistical difference of KAI1 levels in normal and cancerous papilla. No association between KAI1 mRNA expression and tumor stage or tumor differentiation was found in the tumors. By immunohistochemical assay, KAI1 staining in cytoplasm of papillary cancer cells was similar to that of normal papillary cells. By in situ hybridization, the results of KAI1 mRNA expression in normal and cancerous papilla were similar to those with immunohistochemical assay. The normal and cancerous pancreas tissues were also analyzed by the methods used in papillary samples. CONCLUSION Although the biologic roles of KAI1 have not been clarified, our results suggest that KAI1 may restrict the progression of malignant papillary cancer, but its expression might not have any effect on the characteristics of papillary tumor, whereas by the analysis of KAI1 gene, its reduced expression is closely related to the progression and metastases of pancreatic cancer.

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Surgical strategy for carcinoma of the papilla of vater on the basis of lymphatic spread and mode of recurrence

Cited by 86 publications

References 15 publications

Surgical Outcomes and Prognostic Factors for Ampulla of Vater Cancer

Surgical Outcomes and Prognostic Factors for Ampulla of Vater Cancer

Estudo da linfadenectomia radical comparada à linfadenectomia standard no tratamento cirúrgico do adenocarcinoma da papila de Vater

KAI1 gene is differently expressed in papillary and pancreatic cancer: Influence on metastasis

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