Survival analysis after pancreatic resection for ampullary and pancreatic head carcinoma: An analysis of clinicopathological factors

• Published in: Journal of surgical oncology Vol. 100; no. 8; pp. 651 - 656
• Main Authors: Sommerville, C.A.M., Limongelli, P., Pai, M., Ahmad, R., Stamp, G., Habib, N.A., Williamson, R.C.N., Jiao, L.R.
• Format: Journal Article
• Language: English
• Published: Hoboken Wiley Subscription Services, Inc., A Wiley Company 15.12.2009
• Subjects: Adult; Aged; Ampulla of Vater; ampullary carcinomas; Common Bile Duct Neoplasms - mortality; Common Bile Duct Neoplasms - pathology; Common Bile Duct Neoplasms - surgery; Humans; Middle Aged; pancreatic carcinomas; Pancreatic Neoplasms - mortality; Pancreatic Neoplasms - pathology; Pancreatic Neoplasms - surgery; Pancreaticoduodenectomy; survival differences
• ISSN: 0022-4790; 1096-9098
• DOI: 10.1002/jso.21390

Background and Objectives Surgery remains the only curative option for the treatment of pancreatic and ampullary carcinomas. To examine the survival differences between ampullary and pancreatic head carcinomas after pancreaticoduodenectomy. Methods A retrospective review of patients with ampullary or pancreatic head adenocarcinoma undergoing curative resection during a 6‐year period prior to 2000. Results A total of 104 patients underwent pancreaticoduodenectomy for pancreatic head and ampullary carcinomas (n = 65 and n = 39, respectively). Histologically, pancreatic cancer was worse, with more lymph node involvement and more positive resection margins and vascular and perineural invasions than found in ampullary carcinoma. The median disease‐free and overall survival rates were significantly better for ampullary cancer when compared with pancreatic cancer (17 vs. 9 months [P = 0.001] and 35 vs. 24 months [P = 0.006], respectively). The actuarial 5‐year disease‐free and overall survival rates were 4.4% and 10.5%, respectively, for pancreatic carcinoma and 27.9% and 31.8%, respectively, for ampullary carcinoma. Multivariate analysis showed that microscopic resection margin involvement (P = 0.02) and involvement of over three nodes (P < 0.001) were significant factors affecting the overall survival for pancreatic and ampullary carcinomas, respectively. Conclusions In this study, patients with ampullary carcinoma have a better prognosis and survival than those with pancreatic carcinoma. J. Surg. Oncol. 2009;100:651–656. © 2009 Wiley‐Liss, Inc.