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HPB Surgery
Volume 11, Issue 1, Pages 1-11
http://dx.doi.org/10.1155/1998/60259

Carcinoma of the Ampulla of Vater: Determinants of Long-term Survival in 94 Resected Patients

1Clinic of Abdominal and Transplantation Surgery, Hannover Medical School, Hannover D-30623, Germany
2Institute of Pathology, Hannover Medical School, Hannover D-30623, Germany
3Chirurgische 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.

Abstract

This retrospective study details 94 patients after surgical resection of carcinoma of the ampulla of Vater to determine prognostic factors. The tumour was limited to the ampulla of Vater in 32%, invaded the duodenal wall in 34%, infiltrated 2cm or less into the pancreas in 22%, and invaded more than 2cm into the pancreas and/or other adjacent structures in 11%. Curative resection was accomplished in 97% of cases. After exclusion of perioperative deaths the 1-, 5- and 10-year survival rates were 79.6%, 38.2%, and 31.6%, respectively with a median survival of 3.68 years. 26 patients survived more than five and 15 patients more than ten years. In an univariate analysis advanced tumour size, poor tumour grading, lymph node metastases and advanced UICC stage significantly decreased survival. Comparison of short and long survivors confirmed tumour size, lymph node status and UICC stage as significant prognostic factors. In a multivariate analysis (Cox model), only tumour size was a statistically independent predictor of prognosis. The survival probability increased with each year a patient survived after resection. When a patient had already survived five years after resection, the probability to survive another five years was 83%. Careful clinicopathologic staging is important for the prognosis after resection.