Prognostic factors of ampulla of vater carcinoma after radical surgery

Objective  Ampullary carcinoma is a rare disease with better prognosis than other periampullary neoplasms. This study investigated the association between clinicopathologic factors and prognosis after radical resection of ampulla of Vater carcinoma. Methods  Clinical data from 105 patients who underwent radical pancreaticoduodenectomy from January 1990 to December 2005 were retrospectively analyzed by the Kaplan-Meier method, log-rank test, and the Cox proportional hazard model. Results  The in-hospital mortality rate was 8.6%, the lymph node metastasis rate was 37.1%, and the five-year survival rate was 42.8%. Pancreatic involvement (P = 0.027), tumor diameter (P = 0.008), T stage (P = 0.003), TNM stage (P < 0.001), and number of metastatic lymph nodes (P < 0.001) were associated with prognosis when the univariate analysis was used. Multivariate analysis showed that the number of lymph node metastases (P < 0.001; OR: 1.923; CI: 1.367–2.705) and tumor diameter (P = 0.03; OR: 1.432; CI: 1.035–1.981) were the independent prognostic factors. Conclusion  The number of metastatic lymph nodes and tumor diameter are important pathologic factors predicting prognosis of ampulla of Vater carcinoma after radical resection, and lymph node dissection during the radical surgery effectively improves the survival rate.