S-Space College of Medicine/School of Medicine (의과대학/대학원) Surgery (외과학전공) Journal Papers (저널논문_외과학전공)
Recurrence and prognostic factors of ampullary carcinoma after radical resection: comparison with distal extrahepatic cholangiocarcinoma
- Woo, Sang Myung; Ryu, Ji Kon; Lee, Sang Hyub; Yoo, Ji Won; Park, Joo Kyung; Kim, Yong-Tae; Jang, Jin-Young; Kim, Sun-Whe; Kang, Gyeong Hoon; Yoon, Yong Bum
- Issue Date
- Springer Verlag
- Ann Surg Oncol. 2007 Nov;14(11):3195-201. Epub 2007 Aug 19
- Ampulla of Vater/*pathology/surgery; Bile Ducts, Extrahepatic/*pathology/surgery; Cholangiocarcinoma/*pathology/surgery; Common Bile Duct Neoplasms/*pathology/surgery; Female; Humans; Male; Middle Aged; Neoplasm Recurrence, Local/*diagnosis; Pancreaticoduodenectomy; Prognosis; Retrospective Studies; Survival Rate; Treatment Outcome
- BACKGROUND: Ampullary carcinoma is often considered to have a better prognosis than distal extrahepatic cholangiocarcinoma. However, studies that directly compare the recurrence and histopathological features between the two groups are rare. METHODS: Clinicopathologic factors and the long-term outcomes of 163 patients with ampullary carcinoma after radical resection were retrospectively evaluated and compared with those of 91 patients with distal extrahepatic cholangiocarcinoma. RESULTS: Among the 163 ampullary carcinomas, T1 stage, well-differentiated tumors and perineural invasion were 45 (28%), 73 (45%), and 23 (14%), respectively, whereas, only five (6%) were T1 stage, 15 (17%) were well differentiated, and 63 (69%) showed perineural invasion (p < 0.001, for all) in distal extrahepatic cholangiocarcinomas. More patients with distal extrahepatic cholangiocarcinoma had liver metastasis than ampullary carcinoma (24% vs. 10%, p = 0.004). Multivariate analysis identified venous invasion and perineural invasion as risk factors for recurrence of ampullary carcinoma after radical resection. Only lymph node involvement was identified as a risk factor for recurrence of distal extrahepatic cholangiocarcinoma by multivariate analysis. Overall five-year survival of patients with ampullary cancer was higher than that of patients with distal extrahepatic cholangiocarcinoma (68% vs. 54%; p = 0.033). In patients without lymph node metastasis, a significant difference in survival was also observed between the two groups (p = 0.049). CONCLUSION: Earlier diagnosis and the less frequent occurrence of pathological factors associated with tumor invasiveness in ampullary carcinoma than in distal extrahepatic cholangiocarcinoma may explain its association with a better prognosis.
- 1534-4681 (Electronic)
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