title: Radical resection for carcinoma of the ampulla of Vater.
abstract: One hundred four consecutive patients who underwent radical resection for ampullary cancer between 1965 and 1989 were retrospectively reviewed. Frequent clinical findings included jaundice (67%), significant (greater than 10%) weight loss (42%), and anemia (27%). Eighty-seven patients (84%) underwent a subtotal pancreatectomy, and 17 patients (16%) underwent a total pancreatectomy. The postoperative mortality was 5.7% (six patients), and reoperation for postoperative complications was required in six patients. The 5- and 10-year survival rates were 34% and 25%, respectively. Eight patients died of tumor recurrence more than 5 years after resection. Patient survival was significantly impaired by microscopic lymphatic invasion, regional nodal metastasis, tumor grade, and the epithelium of origin. In a multivariate analysis, only microscopic lymphatic invasion significantly reduced patient survival. Radical resection for ampullary cancer can be performed with a low morbidity and mortality and should remain the procedure of choice for ampullary carcinoma.
authors.affiliation: Department of Surgery, Mayo Clinic, Rochester, MN 55905.
authors.forename: J R
authors.initials: JR
authors.lastname: Monson
authors.forename: J H
authors.initials: JH
authors.lastname: Donohue
authors.forename: G P
authors.initials: GP
authors.lastname: McEntee
authors.forename: D C
authors.initials: DC
authors.lastname: McIlrath
authors.forename: J A
authors.initials: JA
authors.lastname: van Heerden
authors.forename: R G
authors.initials: RG
authors.lastname: Shorter
authors.forename: D M
authors.initials: DM
authors.lastname: Nagorney
authors.forename: D M
authors.initials: DM
authors.lastname: Ilstrup
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014670:Ampulla of Vater / Q000601:surgery*; D003138:Common Bile Duct Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015996:Survival Rate