Staging of carcinoma of the pancreas and ampulla of Vater |
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Authors: | K?re E Bakkevold and Brit Kambestad |
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Institution: | (1) Department of Surgery, Haukeland University Hospital, Haugesund, Norway;(2) Section of Medical Informatics and Statistics, University of Bergen, Norway;(3) Present address: Department of Surgery, Haugesund Hospital, N-5500 Haugesund, Norway |
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Abstract: | Summary Between 1984 and 1987, 472 Norwegian patients with histologically or cytologically verified carcinoma of the pancreas (N=442) and ampulla of Vater (N=30) were accrued and TNM staged according to UICC. The influence of the T, N, and M categories on long-term survival was
evaluated. The T1a and T1b tumors of stage I pancreatic carcinoma had a comparable survival (p=0.68–0.95). A higher T category (T1–T3) predicted a more dismal prognosis (p=0.000). The T1 and T2 carcinomas of the ampulla of Vater had a comparable favorable prognosis, and the T3 and T4 tumors had
a comparable unfavorable prognosis. The N1 vs N0 (p=0.000–0.01) and M1 vs M0 categories (p=0.00–0.003) predicted a more dismal prognosis for both pancreatic and ampullary carcinoma. By logistic regression analyses,
pancreatic tumor extension into peripancreatic fat or nerves and invasion of ampullary carcinomas into duodenal wall, unfavorably
influenced the N1 category (p=0.000–0.04) and tumor diameter influenced the M1 category (p=0.002–0.04) both for pancreatic and ampullary carcinoma. The T, N, and M categories all independently influenced survival
of pancreatic carcinoma (p=0.000–0.003). Only the N category (p=0.01) influenced the prognosis of ampullary carcinomas. |
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Keywords: | Pancreas ampulla of Vater adenocarcinoma TNM stage grouping prognostic factors prospective testing |
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