Carcinoma of the Ampulla of Vater: Determinants of Long-term Survival in 94 Resected PatientsReportar como inadecuado

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HPB Surgery - Volume 11 1998, Issue 1, Pages 1-11

Clinic of Abdominal and Transplantation Surgery, Hannover Medical School, Hannover D-30623, Germany

Institute of Pathology, Hannover Medical School, Hannover D-30623, Germany

Chirurgische Universitätsklinik, Knappschaftskrankenhaus Bochum-Langendreer, Ruhr-Universität Bochum, Bochum D-44892 , Germany

Received 21 September 1996; Accepted 3 October 1997

Copyright © 1998 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


This retrospective study details 94 patients aftersurgical resection of carcinoma of the ampulla ofVater to determine prognostic factors. The tumourwas limited to the ampulla of Vater in 32%, invadedthe duodenal wall in 34%, infiltrated 2cm or lessinto the pancreas in 22%, and invaded more than2cm into the pancreas and-or other adjacent structuresin 11%. Curative resection was accomplishedin 97% of cases. After exclusion of perioperativedeaths the 1-, 5- and 10-year survival rates were79.6%, 38.2%, and 31.6%, respectively with a mediansurvival of 3.68 years. 26 patients survived more thanfive and 15 patients more than ten years. In anunivariate analysis advanced tumour size, poortumour grading, lymph node metastases and advancedUICC stage significantly decreased survival.Comparison of short and long survivors confirmedtumour size, lymph node status and UICC stage assignificant prognostic factors. In a multivariateanalysis Cox model, only tumour size was astatistically independent predictor of prognosis.The survival probability increased with each year apatient survived after resection. When a patient hadalready survived five years after resection, theprobability to survive another five years was 83%.Careful clinicopathologic staging is important forthe prognosis after resection.

Autor: Jürgen Klempnauer, Gerd Jürgen Ridder, Hansjörg Maschek, and Rudolf Pichlmayr



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