Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 11/2007

01-11-2007 | Original Paper

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

Authors: Sang Myung Woo, MD, Ji Kon Ryu, MD, Sang Hyub Lee, MD, Ji Won Yoo, MD, Joo Kyung Park, MD, Yong-Tae Kim, MD, Jin-Young Jang, MD, Sun-Whe Kim, MD, Gyeong Hoon Kang, MD, Yong Bum Yoon, MD

Published in: Annals of Surgical Oncology | Issue 11/2007

Login to get access

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.
Literature
1.
Yeo CJ, Cameron JL, Sohn TA, et al. Six hundred fifty consecutive pancreaticoduodenectomies in the 1990s: pathology, complications, and outcomes. Ann Surg 1997;226(3):248–57PubMedCrossRef
2.
Bouvet M, Gamagami RA, Gilpin EA, et al. Factors influencing survival after resection for periampullary neoplasms. Am J Surg 2000;180(1):13–7PubMedCrossRef
3.
Stephens J, Kuhn J, O’Brien J, et al. Surgical morbidity, mortality, and long-term survival in patients with peripancreatic cancer following pancreaticoduodenectomy. Am J Surg 1997;174(6):600–3PubMedCrossRef
4.
Duffy JP, Hines OJ, Liu JH, et al. Improved survival for adenocarcinoma of the ampulla of Vater: fifty-five consecutive resections. Arch Surg 2003; 138(9):941–8PubMedCrossRef
5.
Bottger TC, Boddin J, Heintz A, Junginger T. Clinicopathologic study for the assessment of resection for ampullary carcinoma. World J Surg 1997; 21(4):379–83PubMedCrossRef
6.
Park SW, Park YS, Chung JB, et al. Patterns and relevant factors of tumor recurrence for extrahepatic bile duct carcinoma after radical resection. Hepatogastroenterology 2004; 51(60):1612–8PubMed
7.
Yoshida T, Matsumoto T, Sasaki A, et al. Prognostic factors after pancreatoduodenectomy with extended lymphadenectomy for distal bile duct cancer. Arch Surg 2002; 137(1):69–73PubMedCrossRef
8.
Sasaki R, Takahashi M, Funato O, et al. Prognostic significance of lymph node involvement in middle and distal bile duct cancer. Surgery 2001; 129(6):677–83PubMedCrossRef
9.
Tompkins RK, Thomas D, Wile A, Longmire WP Jr. Prognostic factors in bile duct carcinoma: analysis of 96 cases. Ann Surg 1981; 194(4):447–57PubMedCrossRef
10.
Nakeeb A, Pitt HA, Sohn TA, et al. Cholangiocarcinoma. A spectrum of intrahepatic, perihilar, and distal tumors. Ann Surg 1996; 224(4):463–73PubMedCrossRef
11.
Albores-Saavedra JHD, Klimstra DS. Tumors of the gallbladder, extrahepatic bile duct, and ampulla of Vater 3rd ed. Washington D.C., 2000
12.
Bettschart V, Rahman MQ, Engelken FJ, et al. Presentation, treatment and outcome in patients with ampullary tumours. Br J Surg 2004; 91(12):1600–7PubMedCrossRef
13.
Talamini MA, Moesinger RC, Pitt HA, et al. Adenocarcinoma of the ampulla of Vater. A 28-year experience. Ann Surg 1997; 225(5):590–9PubMedCrossRef
14.
Beger HG, Thorab FC, Liu Z, et al. Pathogenesis and treatment of neoplastic diseases of the papilla of Vater: Kausch-Whipple procedure with lymph node dissection in cancer of the papilla of Vater. J Hepatobiliary Pancreat Surg 2004; 11(4):232–8PubMedCrossRef
15.
Todoroki T, Koike N, Morishita Y, et al. Patterns and predictors of failure after curative resections of carcinoma of the ampulla of Vater. Ann Surg Oncol 2003; 10(10):1176–83PubMedCrossRef
16.
Balachandran P, Sikora SS, Kapoor S, et al. Long-term survival and recurrence patterns in ampullary cancer. Pancreas 2006; 32(4):390–5PubMedCrossRef
17.
Howe JR, Klimstra DS, Moccia RD, et al. Factors predictive of survival in ampullary carcinoma. Ann Surg 1998; 228(1):87–94PubMedCrossRef
18.
Hsu HP, Yang TM, Hsieh YH, et al. Predictors for patterns of failure after pancreaticoduodenectomy in ampullary cancer. Ann Surg Oncol 2007; 14(1):50–60PubMedCrossRef
19.
Lee JH, Whittington R, Williams NN, et al. Outcome of pancreaticoduodenectomy and impact of adjuvant therapy for ampullary carcinomas. Int J Radiat Oncol Biol Phys 2000; 47(4):945–53PubMedCrossRef
20.
Yoon YS, Kim SW, Park SJ, et al. Clinicopathologic analysis of early ampullary cancers with a focus on the feasibility of ampullectomy. Ann Surg 2005; 242(1):92–100PubMedCrossRef
21.
Brown KM, Tompkins AJ, Yong S, et al. Pancreaticoduodenectomy is curative in the majority of patients with node-negative ampullary cancer. Arch Surg 2005; 140(6):529–32PubMedCrossRef
22.
Yeo CJ, Sohn TA, Cameron JL, et al. Periampullary adenocarcinoma: analysis of 5-year survivors. Ann Surg 1998; 227(6):821–31PubMedCrossRef
23.
Kayahara M, Nagakawa T, Ohta T, et al. Role of nodal involvement and the periductal soft-tissue margin in middle and distal bile duct cancer. Ann Surg 1999; 229(1):76–83PubMedCrossRef
24.
Zerbi A, Balzano G, Leone BE, et al. Clinical presentation, diagnosis and survival of resected distal bile duct cancer. Dig Surg 1998; 15(5):410–6PubMedCrossRef
25.
Murakami Y, Uemura K, Hayashidani Y, et al. pancreatoduodenectomy for distal cholangiocarcinoma: Prognostic impact of lymph node metastasis. World J Surg 2006; 31:337–42CrossRef
26.
Murakami Y, Uemura K, Hayashidani Y, et al. Prognostic significance of lymph node metastasis and surgical margin status for distal cholangiocarcinoma. J Surg Oncol 2007; 95(3):207–12PubMedCrossRef
27.
Jarnagin WR, Fong Y, DeMatteo RP, et al. Staging, resectability, and outcome in 225 patients with hilar cholangiocarcinoma. Ann Surg 2001; 234(4):507–17PubMedCrossRef
28.
Sikora SS, Balachandran P, Dimri K, et al. Adjuvant chemo-radiotherapy in ampullary cancers. Eur J Surg Oncol 2005; 31(2):158–63PubMedCrossRef
29.
Alberts SR, Al-Khatib H, Mahoney MR, et al. Gemcitabine, 5-fluorouracil, and leucovorin in advanced biliary tract and gallbladder carcinoma: a North Central Cancer Treatment Group phase II trial. Cancer 2005; 103(1):111–8PubMedCrossRef
30.
von Delius S, Lersch C, Schulte-Frohlinde E, et al. Phase II trial of weekly 24-hour infusion of gemcitabine in patients with advanced gallbladder and biliary tract carcinoma. BMC Cancer 2005; 5(1):61CrossRef
Metadata
Title
Recurrence and Prognostic Factors of Ampullary Carcinoma after Radical Resection: Comparison with Distal Extrahepatic Cholangiocarcinoma
Authors
Sang Myung Woo, MD
Ji Kon Ryu, MD
Sang Hyub Lee, MD
Ji Won Yoo, MD
Joo Kyung Park, MD
Yong-Tae Kim, MD
Jin-Young Jang, MD
Sun-Whe Kim, MD
Gyeong Hoon Kang, MD
Yong Bum Yoon, MD
Publication date
01-11-2007
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 11/2007
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-007-9537-y

Other articles of this Issue 11/2007

Annals of Surgical Oncology 11/2007 Go to the issue

Breast Oncology

Short-Term and Long-Term Psychosocial Adjustment and Quality of Life in Women Undergoing Different Surgical Procedures for Breast Cancer

Original Papers

Plasminogen Activator System Localization in 60 Cases of Ductal Carcinoma In Situ

Breast Oncology

Intra-operative Sonography: A Valuable Aid During Breast-Conserving Surgery for Occult Breast Cancer

Gastrointestinal Oncology

Short-Term Outcomes After Robotic-Assisted Total Mesorectal Excision for Rectal Cancer

Editorials

Cytoreductive Surgery and Perioperative Intraperitoneal Chemotherapy for Colorectal Carcinomatosis: If at First You Don't Succeed...

Editorials

Lumpectomy or Mastectomy: Is Quality of Life the Tie-Breaker?