Carcinoma of the ampulla of Vater: prognostic factors after curative surgery: a series of 45 cases.
BACKGROUND
Some adjuvant or neoadjuvant therapy could be important for patients operated on for tumours of the ampulla of Vater, especially for those having a higher risk of recurrence.


OBJECTIVE
To evaluate prognostic factors after curative surgery based on a series of 45 cases of malignant tumours of the Oddi sphincter.


METHODS
From 1970 to 1992, a curative resection was performed in 45 patients (age 62.8 (SD 10.1) years) with adenocarcinoma of the ampulla. Surgical procedures included pancreatoduodenectomy (n = 42) and resection of the ampulla (n = 3). Actuarial survival was 44 (SD 9)% at five years.


METHODS
Various prognostic variables were studied: clinical manifestations, macroscopic aspect, differentiation, noninvasive adenomatous component, mucin histochemistry, immunohistochemistry (CEA, CA19.9, p53, Ki67), and accepted classifications (Blumgart and Kennedy, Martin, Yamaguchi and Enjoji, Talbot et al, pTNM).


RESULTS
Variables with prognostic power, in order of importance were: Classification of Talbot et al; CA19.9; pTNM; sialomucins; classification of Yamaguchi and Ejoji; Martin classification; sulphomucins; non-invasive adenomatous component (positive > negative); jaundice; tumour localisation.


CONCLUSIONS
This series confirmed the prognostic power of former classifications and showed the prognostic power of other variables (mucin, non-invasive adenomatous component, CA19.9).
Dorandeu
A
A
Service d'Anatomie Pathologique, Centre Régional Hospitalier Universitaire de Rennes, France.
Raoul
J L
JL
Siriser
F
F
Leclercq-Rioux
N
N
Gosselin
M
M
Martin
E D
ED
Ramée
M P
MP
Launois
B
B
D000230:Adenocarcinoma / Q000737:chemistry / Q000401:mortality / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014670:Ampulla of Vater; D014408:Biomarkers, Tumor / Q000032:analysis; D018395:CA-19-9 Antigen / Q000032:analysis; D002272:Carcinoembryonic Antigen / Q000032:analysis; D003138:Common Bile Duct Neoplasms / Q000737:chemistry / Q000401:mortality / Q000601:surgery*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D019394:Ki-67 Antigen / Q000032:analysis; D008297:Male; D008875:Middle Aged; D009077:Mucins / Q000032:analysis; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D016159:Tumor Suppressor Protein p53 / Q000032:analysis
D014408:Biomarkers, Tumor; D018395:CA-19-9 Antigen; D002272:Carcinoembryonic Antigen; D019394:Ki-67 Antigen; D009077:Mucins; D016159:Tumor Suppressor Protein p53