Long-term follow-up of 24 patients undergoing radical resection for ampullary carcinoma, 1953 to 1988

Abstract

Potentially curative radical pancreaticoduodenectomy for ampullary adenocarcinoma was performed in 24 patients over a 35-year period. The overall operative mortality was 12.5%. Actuarial survival rate at 5 years was 61% +/- 13.4 standard error of the mean (SEM) and subsequently remained unchanged. In the same time period, 21 patients underwent potentially curative radical pancreaticoduodenectomy for periampullary tumors of pancreatic origin. Similar analysis showed an overall operative mortality of 23.8% and a survival rate at 5 years of 27% +/- 12.5 SEM. The results of radical pancreaticoduodenectomy for ampullary carcinoma in the most recent years (1976 to 1988) were compared with those of former years (1953 to 1975). There were no statistically significant differences in the 5-year survival rate; however, the operative mortality decreased from 25% in the former period to 6.3% in the recent period. Survival was dependent on nodal status. The 5-year survival rate was 78% +/- 11.5 SEM in the absence of nodal metastasis versus 50% +/- 25 SEM in the presence of regional nodal metastasis. These findings support the concept that radical pancreaticoduodenectomy offers a realistic probability for cure in a selected group of patients with carcinomas of the ampulla of Vater.

Neoplasms of the Ampulla of Vater with Concurrent Pancreatic Intraductal Neoplasia: A Histological and Molecular Study

“…Typical 5-year survival rates for ampullary adenocarcinoma after pancreaticoduodenectomy are around 60%, compared with the dismal 5-year survival rate of around 3.5% for carcinomas of pancreatic ductal origin (29,30). The patients with ampullary adenoma in this study were all alive and well, with an average follow-up period of 3.8 years, and 62% of patients with ampullary adenocarcinoma were alive and well with a 2.5-year average postoperative follow-up period, figures that are comparable to published survival rates for ampullary adenocarcinoma.…”

“…Surgical resection of ampullary adenomas is associated with low morbidity and mortality, and ampullary adenocarcinoma is more often resectable and has an increased survival time relative to pancreatic adenocarcinoma (2,5,29). Typical 5-year survival rates for ampullary adenocarcinoma after pancreaticoduodenectomy are around 60%, compared with the dismal 5-year survival rate of around 3.5% for carcinomas of pancreatic ductal origin (29,30).…”

Carcinoma of the Ampulla of Vater Associated With or Without Adenoma: A Clinicopathologic Analysis of 198 Cases With Reference to p53 and Ki-67 Immunohistochemical Expressions

“…Carcinoma of the ampulla of Vater has a relatively good prognosis when compared with the case of other biliary tract neoplasms such as pancreatic carcinoma or bile duct carcinoma; nevertheless, its 5-year survival rate ranges from 6 to 61% (1)(2)(3)(4)(5). Carcinoma of the ampulla of Vater can be detected earlier than other biliary tract neoplasms because it involves symptoms such as jaundice or obstructive inflammation that are more easily recognizable.…”

Nodal involvement as an indicator of postoperative liver metastasis in carcinoma of the papilla of Vater

“…Several factors have been variably associated with survival: [2][3][4][5][7][8][9][10][11][12][13][14][15][16][17][18][20][21][22][23][24] tumor size, histological differentiation, lymph node status, resection margin status, and perioperative blood transfusion. In the present series, ulcer formation, histological type, nodal involvement, and lymphatic invasion approached significance as prognostic predictors.…”