Clinicopathologic Analysis of Ampullary Neoplasms in 450 Patients: Implications for Surgical Strategy and Long-Term Prognosis View Full Text


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Article Info

DATE

2009-11-13

AUTHORS

Jordan M. Winter, John L. Cameron, Kelly Olino, Joseph M. Herman, Mechteld C. de Jong, Ralph H. Hruban, Christopher L. Wolfgang, Frederic Eckhauser, Barish H. Edil, Michael A. Choti, Richard D. Schulick, Timothy M. Pawlik

ABSTRACT

BackgroundWhether ampullary neoplasms are best surgically managed by pancreaticoduodenectomy versus local ampullectomy is controversial. We sought to examine the outcome of patients undergoing pancreaticoduodenectomy versus ampullectomy, as well as to identify factors predictive of lymph node metastasis in patients with ampullary neoplasms.MethodsBetween 1970 and 2007, 450 patients who underwent surgical resection of ampullary adenoma or adenocarcinoma were identified from a prospective, single-institution database. Data on clinicopathologic factors, morbidity, mortality, and survival were analyzed.ResultsThe initial surgical procedure was pancreaticoduodenectomy in 96.7% patients and ampullectomy in 3.3%. Final diagnosis was invasive adenocarcinoma (77.1%) or adenoma (22.9%). Median tumor size was similar for adenomas associated with an adenocarcinoma (2.5 cm) versus adenomas without invasive cancer (2.9 cm; P = 0.71). Morbidity was comparable with pancreaticoduodenectomy (52.2%) versus ampullectomy (33.3%; P = 0.15), as was 30-day mortality (pancreaticoduodenectomy, 2.1% versus ampullectomy, 0%; P = 0.6). Metastatic disease to regional lymph nodes was present in 54.5% patients with adenocarcinoma. Factors associated with presence of lymph node metastasis included tumor size ≥1 cm (OR 2.1), poor histologic grade (OR 4.8), perineural invasion (OR 3.0), microscopic vessel invasion (OR 6.6), and depth of invasion > pT1 (OR 4.3; all P < 0.05). Specifically, risk of lymph node metastasis increased with T stage (T1, 28.0%; T2, 50.9%; T3, 71.7%; T4, 77.3%; P < 0.001).ConclusionWhen surgery is indicated, radical resection is required for early invasive adenocarcinoma of the ampulla of Vater, as lymph node metastases are present in nearly 30% of patients with T1 disease. Pancreaticoduodenectomy should be the preferred approach for most ampullary neoplasms that require surgical resection. More... »

PAGES

379-387

References to SciGraph publications

  • 2006-10-20. Predictors for Patterns of Failure after Pancreaticoduodenectomy in Ampullary Cancer in ANNALS OF SURGICAL ONCOLOGY
  • 1997-05. Clinicopathologic Study for the Assessment of Resection for Ampullary Carcinoma in WORLD JOURNAL OF SURGERY
  • 2006-03-08. Local excision as a treatment for tumors of ampulla of Vater in WORLD JOURNAL OF SURGICAL ONCOLOGY
  • 2005-12-01. Pancreaticoduodenectomy with or without distal gastrectomy and extended retroperitoneal lymphadenectomy for periampullary adenocarcinomad—part 3: Update on 5-year survival in JOURNAL OF GASTROINTESTINAL SURGERY
  • 2005-04-21. Transduodenal Resection of Peri-Ampullary Lesions in WORLD JOURNAL OF SURGERY
  • 2006-02-27. Safety and long-term follow-up of endoscopic snare excision of ampullary adenomas in SURGICAL ENDOSCOPY
  • 2008-07. Tumor-related factors and patient’s age influence survival after resection for ampullary adenocarcinoma in JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES
  • 2002-04-12. Ampulla of vater cancers: T-stage and histological subtype but not Dpc4 expression predict prognosis in VIRCHOWS ARCHIV
  • 1996-07. Diagnosis and Therapy for Ampullary Tumors: 63 Cases in WORLD JOURNAL OF SURGERY
  • 2005-03-23. Pancreatoduodenectomy for Tumors of Vater’s Ampulla: Report on 94 Consecutive Patients in WORLD JOURNAL OF SURGERY
  • 2005-08-30. Our local experience with the surgical treatment of ampullary cancer in INTERNATIONAL SEMINARS IN SURGICAL ONCOLOGY
  • 2003-03-01. Role of the DPC4 Tumor Suppressor Gene in Adenocarcinoma of the Ampulla of Vater: Analysis of 140 Cases in MODERN PATHOLOGY
  • 2006-12-05. Carcinoma of the Ampulla of Vater: Factors Influencing Long-term Survival of 127 Patients with Resection in WORLD JOURNAL OF SURGERY
  • 1999-09. Development and Progress in Resective Surgery for Pancreatic Cancer in WORLD JOURNAL OF SURGERY
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s11605-009-1080-7

    DOI

    http://dx.doi.org/10.1007/s11605-009-1080-7

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1029559324

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/19911239


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        "description": "BackgroundWhether ampullary neoplasms are best surgically managed by pancreaticoduodenectomy versus local ampullectomy is controversial. We sought to examine the outcome of patients undergoing pancreaticoduodenectomy versus ampullectomy, as well as to identify factors predictive of lymph node metastasis in patients with ampullary neoplasms.MethodsBetween 1970 and 2007, 450 patients who underwent surgical resection of ampullary adenoma or adenocarcinoma were identified from a prospective, single-institution database. Data on clinicopathologic factors, morbidity, mortality, and survival were analyzed.ResultsThe initial surgical procedure was pancreaticoduodenectomy in 96.7% patients and ampullectomy in 3.3%. Final diagnosis was invasive adenocarcinoma (77.1%) or adenoma (22.9%). Median tumor size was similar for adenomas associated with an adenocarcinoma (2.5\u00a0cm) versus adenomas without invasive cancer (2.9\u00a0cm; P\u2009=\u20090.71). Morbidity was comparable with pancreaticoduodenectomy (52.2%) versus ampullectomy (33.3%; P\u2009=\u20090.15), as was 30-day mortality (pancreaticoduodenectomy, 2.1% versus ampullectomy, 0%; P\u2009=\u20090.6). Metastatic disease to regional lymph nodes was present in 54.5% patients with adenocarcinoma. Factors associated with presence of lymph node metastasis included tumor size \u22651\u00a0cm (OR 2.1), poor histologic grade (OR 4.8), perineural invasion (OR 3.0), microscopic vessel invasion (OR 6.6), and depth of invasion > pT1 (OR 4.3; all P\u2009<\u20090.05). Specifically, risk of lymph node metastasis increased with T stage (T1, 28.0%; T2, 50.9%; T3, 71.7%; T4, 77.3%; P\u2009<\u20090.001).ConclusionWhen surgery is indicated, radical resection is required for early invasive adenocarcinoma of the ampulla of Vater, as lymph node metastases are present in nearly 30% of patients with T1 disease. Pancreaticoduodenectomy should be the preferred approach for most ampullary neoplasms that require surgical resection.", 
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