Skip to main content

Advertisement

SpringerLink
Log in

Prognostic factors of carcinoma of the ampulla of Vater after surgery

  • Research Article
  • Published:
Tumor Biology

Abstract

The purpose of this study was to investigate the prognostic factors of carcinoma of the ampulla of Vater (CAV) after surgery. The clinicopathological factors related to the recurrence and prognosis of 162 CAV patients after surgical resection were retrospectively analyzed using univariate and multivariate methods. The in-hospital mortality rate was 4.32 % and the 5-year disease-free survival and overall survival of the 162 subjects were 55.1 and 51.7 %, respectively. Univariate analysis revealed that an advanced T stage (P = 0.002), lymph nodal metastasis (P = 0.002), poor differentiation (P = 0.006), tumor size (P = 0.033), tumor stage (P = 0.001), carbohydrate antigen (CA) 199 serum levels (P = 0.000), pancreatic invasion (P = 0.001), chemotherapy/radiation therapy (P = 0.006), and jaundice (P = 0.012) were factors that significantly affected the prognosis of CAV. Multivariate analysis showed that the pancreatic invasion (P = 0.009), lymph nodal metastasis (P = 0.009), and increased CA199 serum level (P = 0.001) were independent risk factors of recurrence. The pancreatic invasion, lymph nodal metastasis, and increased CA199 serum level are key prognostic factors of CAV after surgery.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Neugut AI, Jacobson JS, Rella VA. Prevalence and incidence of colorectal adenomas and cancer in asymptomatic persons. Gastrointest Endosc Clin N Am. 1997;7:387–99.

    CAS  PubMed  Google Scholar 

  2. Barauskas G, Gulbinas A, Pranys D, et al. Tumor-related factors and patient’s age influence survival after resection for ampullary adenocarcinoma. J Hepatobiliary Pancreat Surg. 2008;15:423–8.

    Article  PubMed  Google Scholar 

  3. Al Ustwani O, Iancu D, Yacoub R, Iyer R. Detection of circulating tumor cells in cancers of biliary origin. J Gastrointest Oncol. 2012;3:97–104.

    PubMed Central  PubMed  Google Scholar 

  4. Pantel K, Alix-Panabières C. Detection methods of circulating tumor cells. J Thorac Dis. 2012;4:446–7.

    CAS  PubMed Central  PubMed  Google Scholar 

  5. O’Connell JB, Maggard MA, Manunga Jr J, et al. Survival after resection of ampullary carcinoma: a national population-based study. Ann Surg Oncol. 2008;15:1820–7.

    Article  PubMed  Google Scholar 

  6. Yoon YS, Kim SW, Park SJ, et al. Clinicopathologic analysis of early ampullary cancers with a focus on the feasibility of ampullectomy. Ann Surg. 2005;242:92–100.

    Article  PubMed  Google Scholar 

  7. Shiba H, Misawa T, Fujiwara Y, et al. Glasgow prognostic score predicts therapeutic outcome after pancreaticoduodenectomy for carcinoma of the ampulla of vater. Anticancer Res. 2013;33:2715–21.

    PubMed  Google Scholar 

  8. Ma X, Zhang QY. Protein microarrays for quantitative detection of PAI-1 in serum. Chin J Cancer Res. 2012;24:220–5.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  9. Ito K, Fujita N, Noda Y, et al. Diagnosis of ampullary cancer. Dig Surg. 2010;27:115–8.

    Article  PubMed  Google Scholar 

  10. Clary BM, Tyler DS, Dematos P, et al. Local ampullary resection with careful intraoperative frozen section evaluation for presumed benign ampullary neoplasms. Surgery. 2000;127:628–33.

    Article  CAS  PubMed  Google Scholar 

  11. Heinrich S, Clavien PA. Ampullary cancer. Curr Opin Gastroenterol. 2010;26:280–5.

    Article  PubMed  Google Scholar 

  12. Demetriades H, Zacharakis E, Kirou I, et al. Local excision as a treatment for tumors of ampulla of Vater. World J Surg Oncol. 2006;4:14.

    Article  PubMed Central  PubMed  Google Scholar 

  13. Lee SY, Jang KT, Lee KT, et al. Can endoscopic resection be applied for early stage ampulla of Vater cancer? Gastrointest Endosc. 2006;63:783–8.

    Article  PubMed  Google Scholar 

  14. Yoon SM, Kim MH, Kim MJ, et al. Focal early stage cancer in ampullary adenoma: surgery or endoscopic papillectomy? Gastrointest Endosc. 2007;66:701–7.

    Article  PubMed  Google Scholar 

  15. Dixon E, Vollmer Jr CM, Sahajpal A, et al. Transduodenal resection of peri-ampullary lesions. World J Surg. 2005;29:649–52.

    Article  PubMed  Google Scholar 

  16. Hatzaras I, George N, Muscarella P, et al. Predictors of survival in periampullary cancers following pancreaticoduodenectomy. Ann Surg Oncol. 2010;17:991–7.

    Article  PubMed Central  PubMed  Google Scholar 

  17. Duffy JP, Hines OJ, Liu JH, et al. Improved survival for adenocarcinoma of the ampulla of Vater: fifty-five consecutive resections. Arch Surg. 2003;138:941–8.

    Article  PubMed  Google Scholar 

  18. de Paiva Haddad LB, Patzina RA, et al. Lymph node involvement and not the histopathologic subtype is correlated with outcome after resection of adenocarcinoma of the ampulla of vater. J Gastrointest Surg. 2010;14:719–28.

    Article  PubMed  Google Scholar 

  19. Qiao QL, Zhao YG, Ye ML, et al. Carcinoma of the ampulla of Vater: factors influencing long-term survival of 127 patients with resection. World J Surg. 2007;31:137–43.

    Article  PubMed  Google Scholar 

  20. Winter JM, Cameron JL, Olino K, et al. Clinicopathologic analysis of ampullary neoplasms in 450 patients: implications for surgical strategy and long-term prognosis. J Gastrointest Surg. 2010;14:379–87.

    Article  PubMed  Google Scholar 

  21. Riall TS, Cameron JL, Lillemoe KD, et al. Resected periampullary adenocarcinoma: 5-year survivors and their 6- to 10-year follow-up. Surgery. 2006;140:764–72.

    Article  PubMed  Google Scholar 

  22. Roland CL, Katz MH, Gonzalez GM, et al. A high positive lymph node ratio is associated with distant recurrence after surgical resection of ampullary carcinoma. J Gastrointest Surg. 2012;16:2056–63.

    Article  PubMed  Google Scholar 

  23. Sierzega M, Nowak K, Kulig J, et al. Lymph node involvement in ampullary cancer: the importance of the number, ratio, and location of metastatic nodes. J Surg Oncol. 2009;100(1):19–24.

    Article  PubMed  Google Scholar 

  24. Botsios D, Zacharakis E, Lambrou I, et al. Our local experience with the surgical treatment of ampullary cancer. Int Semin Surg Oncol. 2005;2:16.

    Article  PubMed Central  PubMed  Google Scholar 

  25. Lee JH, Whittington R, Williams NN, et al. Outcome of pancreaticoduodenectomy and impact of adjuvant therapy for ampullary carcinomas. Int J Radiat Oncol Biol Phys. 2000;47:945–53.

    Article  CAS  PubMed  Google Scholar 

  26. Beger HG, Treitschke F, Gansauge F, et al. Tumor of the ampulla of Vater: experience with local or radical resection in 171 consecutively treated patients. Arch Surg. 1999;134:526–32.

    Article  CAS  PubMed  Google Scholar 

  27. Hsu HP, Yang TM, Hsieh YH, et al. Predictors for patterns of failure after pancreaticoduodenectomy in ampullary cancer. Ann Surg Oncol. 2007;14:50–60.

    Article  PubMed  Google Scholar 

  28. Zhou G, Chiu D, Qin D, et al. The efficacy evaluation of cryosurgery in pancreatic cancer patients with the expression of CD44v6, integrin-β1, CA199, and CEA. Mol Biotechnol. 2012;52:59–67.

    Article  CAS  PubMed  Google Scholar 

  29. Zhou G, Niu L, Chiu D, et al. Changes in the expression of serum markers CA242, CA199, CA125, CEA, TNF-α and TSGF after cryosurgery in pancreatic cancer patients. Biotechnol Lett. 2012;34:1235–41.

    Article  CAS  PubMed  Google Scholar 

  30. Zhou J, Hsu CC, Winter JM, et al. Adjuvant chemoradiation versus surgery alone for adenocarcinoma of the ampulla of Vater. Radiother Oncol. 2009;92:244–8.

    Article  PubMed Central  PubMed  Google Scholar 

  31. Narang AK, Miller RC, Hsu CC, et al. Evaluation of adjuvant chemoradiation therapy for ampullary adenocarcinoma: the Johns Hopkins Hospital–Mayo Clinic collaborative study. Radiat Oncol. 2011;6:126.

    Article  PubMed Central  PubMed  Google Scholar 

Download references

Conflicts of interest

None

Author information

Authors and Affiliations

  1. Department of Abdominal Surgery, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17, South Panjiayuan Rd, Beijing, 100021, China

    Jianguo Zhou, Peng Li, Yi Shan, Dongbing Zhao & Jianqiang Cai

  2. Department of Surgery, Aero Space Center Hospital, Beijing, 100049, China

    Qian Zhang

Authors
  1. Jianguo Zhou
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Qian Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Peng Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Yi Shan
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Dongbing Zhao
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Jianqiang Cai
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Dongbing Zhao.

Additional information

Jianguo Zhou and Qian Zhang equally contributed to this work.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Zhou, J., Zhang, Q., Li, P. et al. Prognostic factors of carcinoma of the ampulla of Vater after surgery. Tumor Biol. 35, 1143–1148 (2014). https://doi.org/10.1007/s13277-013-1153-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13277-013-1153-9

Keywords

Search

Navigation