Impact of Lymph Node Metastasis on Survival in Patients With Pathological T1 Carcinoma of the Ampulla of Vater

Tanaka, Hiroshi; Uchiyama, Kazuhisa; Tani, Masaji; Kawai, Manabu; Tsuji, Takeshi; Tabuse, Katsuyoshi; Kobayashi, Yasuhito; Taniguchi, K; Yamaue, Hiroki

doi:10.1016/j.gassur.2006.01.013

Cited by 13 publications

(20 citation statements)

References 18 publications

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“…A number of clinicopathologic factors which correlate with survival after resection of ampullary cancer have been identified: lymph node metastasis [2,10,14,15,16], depth of tumor invasion [10], histologic grade [14,16], resection margin [12], perineural invasion [17], lymphovascular invasion [14], and intraoperative transfusion [14,16]. Our study confirms that nodal involvement is a poor prognostic factor.…”

Section: Discussionsupporting

confidence: 78%

“…Lymphatic metastases, hematogenous spread, peritoneal dissemination, and local invasion are the routes of metastases, with lymph node involvement being the most important metastatic routes in CPV [1,2,3,4,10,11,12,13]. A number of clinicopathologic factors which correlate with survival after resection of ampullary cancer have been identified: lymph node metastasis [2,10,14,15,16], depth of tumor invasion [10], histologic grade [14,16], resection margin [12], perineural invasion [17], lymphovascular invasion [14], and intraoperative transfusion [14,16].…”

Section: Discussionmentioning

confidence: 99%

“…Yoon et al [24] reported that PD constituted adequate radical resection, even in CPV. Terasawa et al [10] also reported that 20% of pT1 stage tumors had lymph node metastases. Balachandran et al [14] reported that the tumor category did not influence survival, but our study demonstrated that the depth of tumor invasion affected survival.…”

Section: Discussionmentioning

confidence: 99%

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Gross Appearance of the Ampullary Tumor Predicts Lymph Node Metastasis and Outcome

Kayahara¹,

Ohta²

2010

Dig Surg

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Background/Aims: Patterns of lymph node involvement in carcinoma of the papilla of Vater (CPV) have not been studied in detail to date, and factors associated with lymphatic metastases and surgical outcome of this disease remain to be determined. Methods: Lymph node involvement and surgical outcome of 51 CPV patients were evaluated by extended lymphadenectomy specimens. Results: Lymph nodes with high metastatic potential were posterosuperior pancreaticoduodenal nodes (group 13a, 18%), posterior-inferior pancreaticoduodenal nodes (group 13b, 22%), and nodes around the superior mesenteric artery (group 14, 18%). Gross appearance of the primary tumor and depth of tumor invasion correlated with lymph node involvement (p < 0.05, respectively). A correlation with positivity was also found in groups 13 and 14. Disease-specific survival correlated with the gross appearance of the primary tumor and nodal involvement. However, there was no relationship between survival and the level of nodal involvement. Multivariate analysis indicated that the gross appearance of the tumor was the only significant independent predictor of a poor outcome. Conclusions: Gross appearance of the tumor is the most important prognosticator of lymph node metastases in CPV. Nodal dissection around the superior mesenteric artery may improve survival except in patients without invasion of the sphincter of Oddi. Pylorus-preserving pancreaticoduodenectomy is the treatment of choice.

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Section: Discussionsupporting

confidence: 78%

Section: Discussionmentioning

confidence: 99%

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Gross Appearance of the Ampullary Tumor Predicts Lymph Node Metastasis and Outcome

Kayahara¹,

Ohta²

2010

Dig Surg

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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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Lymph node involvement in ampullary cancer: The importance of the number, ratio, and location of metastatic nodes

Sierżęga

Nowak

Kulig

et al. 2009

Journal of Surgical Oncology

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Impact of Lymph Node Metastasis on Survival in Patients With Pathological T1 Carcinoma of the Ampulla of Vater

Cited by 13 publications

References 18 publications

Gross Appearance of the Ampullary Tumor Predicts Lymph Node Metastasis and Outcome

Gross Appearance of the Ampullary Tumor Predicts Lymph Node Metastasis and Outcome

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

Lymph node involvement in ampullary cancer: The importance of the number, ratio, and location of metastatic nodes

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