Prognostic Factors Influencing Survival in Ampullary Carcinoma after Radical Resection.
- Author:
Jong Gook WOO
1
;
Hyoun Jong MOON
;
Jin Seok HEO
;
Sung Ho CHOI
;
Yong Il KIM
Author Information
1. Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. jsheo@smc.samsung.co.kr
- Publication Type:Original Article
- Keywords:
Ampullary carcinoma;
Pancreaticoduodenectomy;
Prognostic factors
- MeSH:
Adenocarcinoma;
Ampulla of Vater;
Female;
Humans;
Lymph Nodes;
Male;
Medical Records;
Mortality;
Multivariate Analysis;
Neoplasm Metastasis;
Pancreatectomy;
Pancreaticoduodenectomy;
Proportional Hazards Models;
Pylorus;
Retrospective Studies;
Survival Rate
- From:Journal of the Korean Surgical Society
2003;65(5):408-412
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: This retrospective study was aimed to determine prognostic factors after radical resection of an ampullary carcinoma. METHODS: Medical records of patients with adenocarcinoma of the ampulla of Vater who had undergone pancreaticoduodenectomy between Dec. 1994 and May 2002 were reviewed. This study included 59 men and 40 women with a mean age of 58.9 years. 62 patients underwent Whipple procedures, 36 patients, pylorus preserving pancreaticoduodenectomy and 1 patient, total pancreatectomy. Actuarial survival rates were calculated using the Kaplan-Meier method. A Cox proportional hazards model was used to test the independent predictors of survival. P<0.05 was considered statistically significant. RESULTS: The overall 5-year survival rate was 45.4% with 3% mortality and 34.3% morbidity. According to the pTNM stage, the 5-year survival rates were 91.7%, 54.3%, 28.5% and 0% at stages I, II, III, and IV (P<0.01), respectively. The patient survival was significantly impaired by the depth of invasion, lymph node metastasis and intraoperative transfusion (P<0.05). In a multivariate analysis, only lymph node metastasis was a statistically independent prognostic factor. CONCLUSION: pTNM stage is a good prognostic indicator for an ampullary carcinoma after pancreaticoduodenectomy and patients with lymph node metastasis should be identified as high risk and considered as candidates for further adjuvant therapy.
