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Prognostic factors for survival of patients with ampullary carcinoma after local resection
Author(s) -
Zhao Xiangqian,
Dong Jiahong,
Huang Xiaoqiang,
Zhang Wenzhi,
Jiang Kai
Publication year - 2014
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/ans.12600
Subject(s) - medicine , pancreaticoduodenectomy , pathological , survival rate , resection margin , carcinoma , biopsy , gastroenterology , overall survival , surgery , resection
Background Local resection ( LR ) is a potentially effective alternative to pancreaticoduodenectomy for treatment of ampullary cancer, but the prognostic factors remain undefined. The purpose of this study was to identify the prognostic factors for ampullary cancer patients who had undergone LR . Methods We retrospectively reviewed the clinical, pathological data and surgical approach of 34 ampullary cancer patients who had undergone LR during 1996–2009 at P eople's L iberation A rmy G eneral H ospital. Prognostic factors for survival and recurrence were analysed. Results The 1‐, 3‐ and 5‐year survival rates of the patients were 97.1, 69.5 and 53.7%, respectively. The gender, age, preoperative bilirubin levels, CA 19‐9 levels and preoperative biopsy did not correlate with the survival rates. The survival rates of patient with T 1 and T 2 tumours were superior to that of patients with T 3 tumours ( P = 0.000). Tumour size, surgical margin status and the extent of differentiation had no effect on survival rates ( P = 0.464, P = 0.601 and P = 0.121, respectively). The survival rate of patients who had extraduodenal LR (12 cases) was superior to that of patients who had transduodenal LR (22 cases) ( P = 0.026). Tumour recurrence occurred in 14 (41.2%) patients. Tumour infiltration ( P = 0.014) correlated with the recurrence. Conclusion The degree of tumour infiltration is the pathological factor that most affects the survival of ampullary cancer patients who undergo LR . Extraduodenal LR is a promising surgical procedure, the efficacy of which is superior to that of transduodenal LR . The depth of tumour invasion correlated with the recurrence.