World Journal of Surgery

, Volume 31, Issue 1, pp 137–143

Carcinoma of the Ampulla of Vater: Factors Influencing Long-term Survival of 127 Patients with Resection

Authors

    • Department of SurgeryFirst Hospital, Peking University
  • Yi-guo Zhao
    • Department of SurgeryFirst Hospital, Peking University
  • Mu-lin Ye
    • Department of SurgeryFirst Hospital, Peking University
  • Yin-mo Yang
    • Department of SurgeryFirst Hospital, Peking University
  • Jian-xun Zhao
    • Department of SurgeryFirst Hospital, Peking University
  • Yan-ting Huang
    • Department of SurgeryFirst Hospital, Peking University
  • Yuan-lian Wan
    • Department of SurgeryFirst Hospital, Peking University
Article

DOI: 10.1007/s00268-006-0213-3

Cite this article as:
Qiao, Q., Zhao, Y., Ye, M. et al. World J. Surg. (2007) 31: 137. doi:10.1007/s00268-006-0213-3

Abstract

Introduction

The prognosis for patients with carcinoma of the ampulla of Vater is improved relative to other periampullary neoplasms. Identification of independent prognostic factors in ampullary carcinomas has been limited by the small number of tumors resected. The aim of the present study was to determine the clinicopathologic factors that influence long-term survival in patients with resected ampullary carcinoma.

Methods

Clinicopathologic data were retrospectively reviewed for patients with ampullary carcinomas radically resected between March 1987 and September 2002. The correlation between clinicopathologic variables and survival of patients after resection was examined by the Kaplan-Meier method, the log-rank test, and Cox proportional hazards regression. Ampullary carcinomas were radically resected in 127 patients either by pancreaticoduodenectomy (n = 124) or local resection (n = 3).

Results

Hospital mortality was 9.7%. The overall actuarial survival rates (including hospital deaths) at 1, 3, 5, and 10 years were 76.2%, 46.8%, 43.3%, and 35.7%, respectively. Factors that significantly influenced survival were lymph node status (P < 0.001), depth of tumor infiltration (P = 0.029), and TNM stage (P < 0.001) on univariate analysis. On multivariate analysis, both depth of infiltration and lymph node status were the independent determinants of survival after resection (P = 0.003, P = 0.005, respectively).

Conclusions

Carcinoma of the ampulla of Vater has a higher resectability rate and a much better survival rate than pancreatic cancer. Pancreaticoduodenectomy is the treatment of choice for this tumor. Long-term survival was independently influenced by the depth of tumor infiltration and lymph node metastasis.

Copyright information

© Société Internationale de Chirurgie 2006