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Annals of Surgical Oncology

, Volume 14, Issue 11, pp 3195–3201 | Cite as

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

  • Sang Myung Woo
  • Ji Kon Ryu
  • Sang Hyub Lee
  • Ji Won Yoo
  • Joo Kyung Park
  • Yong-Tae Kim
  • Jin-Young Jang
  • Sun-Whe Kim
  • Gyeong Hoon Kang
  • Yong Bum Yoon
Original Paper Gastrointestinal Oncology

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.

Keywords

Ampulla of Vater Cholangiocarcinoma Pancreaticoduodenectomy Prognosis Recurrence 

Notes

Acknolwedgements

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

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Copyright information

© Society of Surgical Oncology 2007

Authors and Affiliations

  • Sang Myung Woo
    • 1
  • Ji Kon Ryu
    • 1
    • 4
  • Sang Hyub Lee
    • 1
  • Ji Won Yoo
    • 1
  • Joo Kyung Park
    • 1
  • Yong-Tae Kim
    • 1
  • Jin-Young Jang
    • 2
  • Sun-Whe Kim
    • 2
  • Gyeong Hoon Kang
    • 3
  • Yong Bum Yoon
    • 1
  1. 1.Department of Internal MedicineLiver Research Institute, Seoul National University College of MedicineJongno-guKorea (ROK)
  2. 2.Department of SurgerySeoul National University College of MedicineSeoulKorea
  3. 3.Department of PathologySeoul National University College of MedicineSeoulKorea
  4. 4.Department of Internal MedicineSeoul National University Hospital, Seoul National University College of MedicineJongno-guKorea

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