Abstract
Background and Objectives
Surgery remains the only curative option for the treatment of pancreatic and ampullary carcinomas. To examine the survival differences between ampullary and pancreatic head carcinomas after pancreaticoduodenectomy.
Methods
A retrospective review of patients with ampullary or pancreatic head adenocarcinoma undergoing curative resection during a 6βyear period prior to 2000.
Results
A total of 104 patients underwent pancreaticoduodenectomy for pancreatic head and ampullary carcinomas (nβ=β65 and nβ=β39, respectively). Histologically, pancreatic cancer was worse, with more lymph node involvement and more positive resection margins and vascular and perineural invasions than found in ampullary carcinoma. The median diseaseβfree and overall survival rates were significantly better for ampullary cancer when compared with pancreatic cancer (17 vs. 9 months [Pβ=β0.001] and 35 vs. 24 months [Pβ=β0.006], respectively). The actuarial 5βyear diseaseβfree and overall survival rates were 4.4% and 10.5%, respectively, for pancreatic carcinoma and 27.9% and 31.8%, respectively, for ampullary carcinoma. Multivariate analysis showed that microscopic resection margin involvement (Pβ=β0.02) and involvement of over three nodes (Pβ<β0.001) were significant factors affecting the overall survival for pancreatic and ampullary carcinomas, respectively.
Conclusions
In this study, patients with ampullary carcinoma have a better prognosis and survival than those with pancreatic carcinoma. J. Surg. Oncol. 2009;100:651β656. Β© 2009 WileyβLiss, Inc.