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Recurrence and Prognostic Factors of Ampullary Carcinoma after Radical Resection: Comparison with Distal Extrahepatic Cholangiocarcinoma

  • Original Paper
  • Gastrointestinal Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

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.

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Acknolwedgements

This study was supported in part by the Seoul National University Hospital research fund (grant no. 04-2005-010).

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Authors and Affiliations

  1. Department of Internal Medicine, Liver Research Institute, Seoul National University College of Medicine, 28 Yeongeon-dong, Jongno-gu, Seoul, Korea (ROK)

    Sang Myung Woo MD, Ji Kon Ryu MD, Sang Hyub Lee MD, Ji Won Yoo MD, Joo Kyung Park MD, Yong-Tae Kim MD & Yong Bum Yoon MD

  2. Department of Surgery, Seoul National University College of Medicine, Seoul, Korea

    Jin-Young Jang MD & Sun-Whe Kim MD

  3. Department of Pathology, Seoul National University College of Medicine, Seoul, Korea

    Gyeong Hoon Kang MD

  4. Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, 28 Yeongeon-dong, Jongno-gu, Seoul, 110-744, Korea

    Ji Kon Ryu MD

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  1. Sang Myung Woo MD
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Correspondence to Ji Kon Ryu MD.

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Woo, S.M., Ryu, J.K., Lee, S.H. et al. Recurrence and Prognostic Factors of Ampullary Carcinoma after Radical Resection: Comparison with Distal Extrahepatic Cholangiocarcinoma. Ann Surg Oncol 14, 3195–3201 (2007). https://doi.org/10.1245/s10434-007-9537-y

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  • DOI: https://doi.org/10.1245/s10434-007-9537-y

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