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Annals of Surgical Oncology
Erschienen in:

02.08.2024 | Pancreatic Tumors

Clinical Implications of the Degree of Pancreatic Invasion in Ampulla of Vater Carcinoma

verfasst von: Yuya Miura, MD, Katsuhisa Ohgi, MD, Nobuyuki Ohike, MD, Ryo Ashida, MD, Mihoko Yamada, MD, Shimpei Otsuka, MD, Yoshiyasu Kato, MD, Tomoko Norose, MD, Takashi Sugino, MD, Katsuhiko Uesaka, MD, Teiichi Sugiura, MD

Erschienen in: Annals of Surgical Oncology | Ausgabe 12/2024

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Abstract

Background

Ampulla of Vater carcinoma (AVC) stage T3 was subdivided according to the degree of pancreatic invasion into T3a (≤ 0.5 cm) and T3b (> 0.5 cm) by the 8th edition of the Union for International Cancer Control (UICC)/American Joint Committee on Cancer (AJCC) cancer staging system. However, the differences in clinicopathological features and survival outcomes between the two categories have not been well discussed.

Patients and Methods

We retrospectively analyzed 133 consecutive patients who underwent pancreatoduodenectomy for AVC at our institution between 2002 and 2020. Clinicopathological features and survival outcomes of patients with AVC were analyzed, with a focus on the depth of pancreatic invasion. In addition, the survival outcomes of patients with T3 AVC were compared with those of patients with resectable pancreatic head carcinoma (R-PhC) who underwent pancreatoduodenectomy during the same period.

Results

The overall survival (OS) in patients with T3b AVC (n = 12) was significantly worse than that in patients with T3a AVC (n = 39) [median survival time (MST) 9.2 vs. 74.5 months, p < 0.001). A multivariate analysis identified T3b tumor (hazard ratio 5.64, p = 0.009) as an independent prognostic factor. The OS of patients with T3a AVC was significantly better than that of patients with R-PhC who received adjuvant chemotherapy (n = 276, MST 35.0 months, p = 0.007). In contrast, the OS of patients with T3b AVC tended to be worse than that of patients with R-PhC managed without adjuvant chemotherapy, although this difference was not statistically significant (n = 163; MST, 17.5; p = 0.140).

Conclusions

AVC with > 0.5 cm invasion into the pancreas was associated with poor survival and represented advanced tumor progression to systemic disease.
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Metadaten
Titel
Clinical Implications of the Degree of Pancreatic Invasion in Ampulla of Vater Carcinoma
verfasst von
Yuya Miura, MD
Katsuhisa Ohgi, MD
Nobuyuki Ohike, MD
Ryo Ashida, MD
Mihoko Yamada, MD
Shimpei Otsuka, MD
Yoshiyasu Kato, MD
Tomoko Norose, MD
Takashi Sugino, MD
Katsuhiko Uesaka, MD
Teiichi Sugiura, MD
Publikationsdatum
02.08.2024
Verlag
Springer International Publishing
Erschienen in
Annals of Surgical Oncology / Ausgabe 12/2024
Print ISSN: 1068-9265
Elektronische ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-024-15934-1

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