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John R. T. Monson, MD, FRCSI, FRCS; John H. Donohue, MD; Gerard P. McEntee, MD, FRCSI; Donald C. Mcllrath, MD; Jon A. van Heerden, MB, FRCSC; Roy G. Shorter, MD, FRCP; David M. Nagorney, MD; Duane M. Ilstrup, MS

Arch Surg. 1991;126(3):353-357.

Abstract
• One hundred four consecutive patients who underwent radical resection for ampullary cancer between 1965 and 1989 were retrospectively reviewed. Frequent clinical findings included jaundice (67%), significant (>10%) weight loss (42%), and anemia (27%). Eighty-seven patients (84%) underwent a subtotal pancreatectomy, and 17 patients (16%) underwent a total pancreatectomy. The postoperative mortality was 5.7% (six patients), and reoperation for postoperative complications was required in six patients. The 5-and 10-year survival rates were 34% and 25%, respectively. Eight patients died of tumor recurrence more than 5 years after resection. Patient survival was significantly impaired by microscopic lymphatic invasion, regional nodal metastasis, tumor grade, and the epithelium of origin. In a multivariate analysis, only microscopic lymphatic invasion significantly reduced patient survival. Radical resection for ampullary cancer can be performed with a low morbidity and mortality and should remain the procedure of choice for ampullary carcinoma.

(Arch Surg. 1991;126:353-357)

Author Affiliations
From the Departments of Surgery (Drs Monson, Donohue, McEntee, McIlrath, van Heerden, and Nagorney), Pathology (Dr Shorter), and Biostatistics (Mr Ilstrup), Mayo Clinic and Foundation, Rochester, Minn.

Footnotes
Accepted for publication November 17, 1990.

Read before the 43rd Annual Cancer Symposium of the Society of Surgical Oncology, Washington, DC, May 21, 1990.

Reprint requests to Department of Surgery, Mayo Clinic, Rochester, MN 55905 (Dr Donohue).

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