Pancreatic invasion is a prognostic indicator after radical resection for carcinoma of the ampulla of Vater |
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Authors: | Nobuhiko Harada Frank Treitschke Toshihide Imaizumi Hans G Beger |
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Institution: | 1. Department of General Surgery, University of Ulm, Steinh?velstra?e 9, D-89075, Ulm, Germany 2. Department of Gastroenterological Surgery, Tokyo Women's Medical College, Tokyo, Japan
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Abstract: | Sixty-three patients who had undergone pancreatoduodenectomy for carcinoma of the ampulla of Vater were analyzed with respect to tumor extent and prognosis. The postoperative mortality rate was 3% and overall survival rates 3 and 5 years after surgery were 55% and 46%, respectively. pTNM stage did not reflect prognosis after resection in patients at stages 2 and 3, while pancreatic invasion and regional lymph node metastasis clearly reflected prognosis after resection. Of the 26 patients who had no pancreatic invasion, regional lymph node metastasis was seen in only 19%, whereas of the 37 patients with pancreatic invasion, 62% exhibited lymph node metastasis. These factors were significantly correlated (P<0.001). Pancreatic invasion appeared to be an indirect indicator of regional lymph node metastasis. We conclude that, to improve prognosis for patients with pancreatic invasion, extended resection including extended lymphadenectomy, is a preferable additional procedure. |
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Keywords: | carcinoma of the ampulla of Vater pancreatoduodenectomy pancreatic invasion of carcinoma of the ampulla of Vater lymph node metastasis of carcinoma of the ampulla of Vater prognosis of carcinoma of the ampulla of Vater |
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