Intestinal-type and Pancreatobiliary-type Adenocarcinomas: How Does Ampullary Carcinoma Differ from Other Periampullary Malignancies?

Abstract

Long-term survival for patients with ampullary carcinomas equals pancreatic, biliary, and duodenal carcinomas when the same histologic type is compared. It can be questioned whether ampullary carcinomas should be regarded as a separate entity in classification of solid tumors. Clinical trials on adjuvant treatments for periampullary carcinomas should stratify by pancreatobiliary type versus intestinal type of histologic differentiation.

Histomorphologic and molecular phenotypes predict gemcitabine response and overall survival in adenocarcinoma of the ampulla of Vater

“…according to criteria previously reported. 4,5,15 In brief, IT-PapCa was defined by tubular to elongated glands, cribriform, or solid nests of columnar cells with pseudostratified nuclei closely resembling colorectal adenocarcinoma (Fig 2, F). PT-PapCa consists of simple or branching glands as well as solid nests of mainly cuboidal cells with a high degree of nuclear pleomorphism surrounded by striking desmoplastic stroma (Fig 2, E).…”

“…4,5 Indeed, among patients with PapCa, there is a broad interindividual range of outcomes that impairs the prediction of specific outcomes and clinical decision making as to individual adjuvant therapy. [6][7][8][9][10][11] Kimura et al 12 suggested to subdivide PapCa into intestinal type (IT) and pancreaticobiliary type (PT) emphasizing those as main tumor ''subtypes.''…”

Better Outcome of XELOX Chemotherapy in Patients with Advanced Intestinal-Type Adenocarcinoma of the Ampulla of Vater

“…Moreover, molecular classification makes it possible to observe different biological behaviors and distinguish two subtypes of AAC based on immunohistochemistry Chu et al 2005;Sessa et al 2007;Amptoulach et al 2011;Westgaard et al 2013). Specially, the intestinal epithelial-specific marker, caudaltype homeodomain transcription factor 2 (CDX2) was an independent good prognostic marker for resected AAC (Hansel et al 2005).…”

Molecular signatures of mRNAs and miRNAs as prognostic biomarkers in pancreatobiliary and intestinal types of periampullary adenocarcinomas

“…The patients suffering from adenocarcinoma of intestinal type do better than patients with adenocarcinoma of pancreatobiliary type (Albores-Saavedra et al, 2007, Westgaard et al, 2008. Patients with tumors of the same histological subtype, but from different anatomical site of origin, have similar overall survival (Westgaard et al, 2013). Due to the differences in pathogenesis and survival, accurate histological classification of the periampullary adenocarcinomas is crucial for an adequate prognostic estimation and an individualized therapeutic decision.…”