[Evaluation of treatment for carcinoma of the papilla of Vater].
105 cases of resected carcinoma of the papilla of Vater were studied and 5-year cumulative survival rate of PD was 56.5% and that of each stage was as follows: stage I 93.3%, stage II 70.2%, stage III 7.3%, stage IV 0%. The most significant histological factor influencing on prognosis was pancreatic invasion. 3-year survival rate of panc1a was 75.0%, significantly much better than that of panc1b (29.8%). The lymph node metastasis was frequently noted at no. 14 (11.5%). All of no. 14 lymph-adenectomy and no. 16 lymph-adenectomy on the case suspected as pancreatic parenchymal invasion, produced long-term survive even with metastasis of no. 14. This method led improvement of prognosis of stage II and stage III determined by lymph node factor. However, each prognosis of panc 1b, 2, 3 cases was not improved by this method, especially panc2, 3 cases survived fewer than only 2 years. Extended lymphadenectomy and multimodality therapy were needed on the cases which were suspected as pancreatic parenchymal invasion.
Kinoshita
H
H
Second Department of Surgery, Kurume University School of Medicine, Japan.
Nakayama
T
T
Fukuda
S
S
Imayama
H
H
D014670:Ampulla of Vater; D003138:Common Bile Duct Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D009361:Neoplasm Invasiveness; D010179:Pancreas / Q000473:pathology; D011379:Prognosis; D015996:Survival Rate