Adenocarcinoma of the ampulla of Vater : predictors of survival and recurrence after curative radical resection :predictors of survival and recurrence after curative radical resection

Kang Jae Kim; Dong Wook Choi; Woo Seok Kim; Min Jung Kim; Sun Choon Song; Jin Seok Heo; Seong Ho Choi

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자료유형: 학술저널

저자정보: Kang Jae Kim (Samsung Medical Center, Sungkyunkwan University School of Medicine) Dong Wook Choi (Samsung Medical Center, Sungkyunkwan University School of Medicine) Woo Seok Kim (Samsung Medical Center, Sungkyunkwan University School of Medicine) Min Jung Kim (Samsung Medical Center, Sungkyunkwan University School of Medicine) Sun Choon Song (Samsung Medical Center, Sungkyunkwan University School of Medicine) Jin Seok Heo (Samsung Medical Center, Sungkyunkwan University School of Medicine) Seong Ho Choi (Samsung Medical Center, Sungkyunkwan University School of Medicine)

저널정보: 한국간담췌외과학회 Annals of Hepato-Biliary-Pancreatic Surgery 한국간담췌외과학회지 제15권 제3호

발행연도: 2011.9

수록면: 171 - 178 (8page)

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Backgrounds/Aims: Because of low incidence rates, there have been few reports on the patterns of and risk factors for recurrence after curative resection of the ampulla of Vater (AoV) cancer. The aim of this study was to characterize patterns of recurrence and to evaluate risk factors affecting survival rates and recurrence after curative resection. Methods: Medical records of 181 patients who had undergone pancreaticoduodenectomy with curative intent for AoV adenocarcinoma between December 1994 and March 2010 at Samsung Medical Center were retrospectively reviewed. Factors influencing on overall survival rate, recurrence rates, and recurrence patterns were analyzed. Results: Lymph node metastases and high preoperative serum carcinoembryonic antigen (CEA) level ＞5 ng/ml were identified as independent factors affecting overall survival (p=0.006, p＜0.001, respectively). Among the 181 patients, 69 developed local or distant recurrence within 3 years after curative resection. Lymph node metastasis, preoperative serum CEA level ＞5 ng/ml, and total bilirubin level ＞1.5 mg/dl were identified as independent prognostic factors of recurrence after curative resection (p=0.008, p＜0.001, p=0.003, respectively). Conclusions: AoV adenocarcinoma has a better prognosis than other periampullary carcinomas, but still has a high recurrence rate, especially during the first three years after curative radical resection. Therefore, careful follow-up is needed during the first 3 years, especially for the higher risk group. Further study of adjuvant therapy to decrease recurrence after curative resection is now warranted. (Korean J Hepatobiliary Pancreat Surg 2011;15:171-178)

#Ampulla of Vater #Adenocarcinoma #Pancreaticoduodenectomy #Prognosis #Recurrence

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