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Factors influencing recurrence after curative resection for ampulla of vater carcinoma

 Joon Seong Park  ;  Dong Sup Yoon  ;  Byong Ro Kim  ;  Hoon Sang Chi  ;  Woo Jung Lee  ;  Jin Sub Choi  ;  Kyung Sik Kim 
 JOURNAL OF SURGICAL ONCOLOGY, Vol.95(4) : 286-290, 2007 
Journal Title
Issue Date
Adenocarcinoma/secondary ; Adenocarcinoma/surgery* ; Ampulla of Vater/pathology ; Ampulla of Vater/surgery* ; Common Bile Duct Neoplasms/pathology ; Common Bile Duct Neoplasms/surgery* ; Duodenal Neoplasms/secondary ; Duodenal Neoplasms/surgery* ; Female ; Follow-Up Studies ; Humans ; Lymphatic Metastasis/pathology ; Male ; Middle Aged ; Neoplasm Recurrence, Local/pathology ; Neoplasm Recurrence, Local/surgery* ; Neoplasm Staging ; Pancreatic Neoplasms/secondary ; Pancreatic Neoplasms/surgery* ; Pancreaticoduodenectomy ; Prognosis ; Survival Rate ; Treatment Outcome
BACKGROUND: Carcinoma of the ampulla of Vater has a relatively higher resection rate, lower recurrence rate, and more favorable prognosis than other malignant tumors of the periampullary region. Because of the relative low incidence of carcinoma of the ampulla of Vater, there have been few reports on the patterns and risk factors of recurrence after curative resection. The aim of this study was to evaluate the patterns and risk factors of recurrence after curative resection of ampulla of Vater carcinoma. MATERIALS AND METHODS: Between January 1992 and December 2002, 102 patients received radical resection for ampulla of Vater carcinoma at Yonsei University Medical Center. Fifteen patients were excluded because of incomplete clinicopathologic data. Finally, 87 patients were reviewed and analyzed to assess predictors of tumor recurrence. RESULTS: Among the 87 patients, 37 patients (42.5%) experienced recurrent disease. The mean length of time to recurrence was 29.3 +/- 35.3 months, and the most common sites of recurrence were the intra-abdominal organs: liver and loco-regional lymph nodes. The patients were divided into two groups: early recurrence (<or=18 months) and late recurrence (>18 months). In the early recurrence group, ulcer formation tumors and poorly differentiated tumors were more common in comparison with the late recurrence group. Lymph node metastasis was identified as an independent factor of tumor recurrence after curative resection for ampulla of Vater carcinoma. CONCLUSION: Lymph node metastasis is the most important risk factor for recurrence after a curative resection. Also, the fact that a higher probability of recurrence is anticipated in cases of ulcer formation and poorly differentiated tumors, there exists a need for a close-up follow-up program.
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1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Kyung Sik(김경식) ORCID logo https://orcid.org/0000-0001-9498-284X
Kim, Byong Ro(김병로)
Park, Joon Seong(박준성) ORCID logo https://orcid.org/0000-0001-8048-9990
Yoon, Dong Sup(윤동섭) ORCID logo https://orcid.org/0000-0001-6444-9606
Lee, Woo Jung(이우정) ORCID logo https://orcid.org/0000-0001-9273-261X
Chi, Hoon Sang(지훈상)
Choi, Jin Sub(최진섭)
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