Radical resection for carcinoma of the ampulla of Vater
J. R. Monson, J. H. Donohue, G. P. McEntee, D. C. McIlrath, J. A. van Heerden, R. G. Shorter, D. M. Nagorney and D. M. Ilstrup
Department of Surgery, Mayo Clinic, Rochester, MN 55905.
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 (greater
than 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.
Survival After Resection of Ampullary Carcinoma: A National Population-Based Study
O'Connell et al.
Ann. Surg. Oncol. 2008;15:1820-1827.
ABSTRACT
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Predictors for Patterns of Failure after Pancreaticoduodenectomy in Ampullary Cancer
Hsu et al.
Ann. Surg. Oncol. 2007;14:50-60.
ABSTRACT
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Limitations of Ampullectomy in the Treatment of Nonfamilial Ampullary Neoplasms
Roggin et al.
Ann. Surg. Oncol. 2005;12:971-980.
ABSTRACT
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Pancreaticoduodenectomy Is Curative in the Majority of Patients With Node-Negative Ampullary Cancer
Brown et al.
Arch Surg 2005;140:529-533.
ABSTRACT
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Patterns and Predictors of Failure after Curative Resections of Carcinoma of the Ampulla of Vater
Todoroki et al.
Ann. Surg. Oncol. 2003;10:1176-1183.
ABSTRACT
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Improved Survival for Adenocarcinoma of the Ampulla of Vater: Fifty-five Consecutive Resections
Duffy et al.
Arch Surg 2003;138:941-950.
ABSTRACT
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Adjuvant Chemoradiotherapy for "Unfavorable" Carcinoma of the Ampulla of Vater: Preliminary Report
Mehta et al.
Arch Surg 2001;136:65-69.
ABSTRACT
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Biliary Tract Cancers
de Groen et al.
NEJM 1999;341:1368-1378.
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