Carcinoma of the Ampulla of Vater: Factors Influencing Long‐term Survival of 127 Patients with Resection

Abstract

Carcinoma of the ampulla of Vater has a higher resectability rate and a much better survival rate than pancreatic cancer. Pancreaticoduodenectomy is the treatment of choice for this tumor. Long-term survival was independently influenced by the depth of tumor infiltration and lymph node metastasis.

The Influence of Prognostic Factors and Adjuvant Chemoradiation on Survival After Pancreaticoduodenectomy for Ampullary Carcinoma

“…Published 5-year overall survival (OS) rates for ampullary carcinoma range from 38% to 68% [1][2][3][4][5][6][7] . There are less published data available for AC than for PC to assist with decisions regarding adjuvant therapy.…”

“…Reported prognostic factors include specimen lymph node involvement, poor histologic grade, positive resection margins, and higher tumor stage (T3/T4 versus T1/T2). 1,3,5,7,10,11 (Tables 1 and 2). During the study period, decisions regarding adjuvant therapy were made by the treating physicians without a consistent policy, but the tendency was to reserve CRT for those patients with high-risk features such as positive nodes.…”

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

“…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.…”

Carcinoma of the papilla of Vater following treatment ofpancreaticobiliary maljunction

“…In addition to complete excision of a choledochal cyst, careful long-term follow-up is necessary; the interval between excision of a choledochal cyst and cancer detection ranges from 1 to 19 years in several reports [6] . Compared with other periampullary carcinomas, including those of the duodenum, bile duct, and pancreas, survival and resectability rates of carcinoma of the papilla of Vater are relatively high [9,10] . In addition to the fact that the rate of resection is one of the predictive factors for survival [9] , early detection is of great importance to provide benefit for patients with carcinoma of the papilla of Vater [11] .…”