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Recurrence and prognostic factors of ampullary carcinoma after radical resection: comparison with distal extrahepatic cholangiocarcinoma
Cited 91 time in
Web of Science
Cited 101 time in Scopus
- Authors
- Issue Date
- 2007-08-22
- Publisher
- Springer Verlag
- Citation
- Ann Surg Oncol. 2007 Nov;14(11):3195-201. Epub 2007 Aug 19
- Keywords
- 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
- Abstract
- 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.
- ISSN
- 1534-4681 (Electronic)
- Language
- English
- URI
- http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=17710498
https://hdl.handle.net/10371/15304
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