title: Importance of microperineural invasion as a prognostic factor in ampullary carcinoma.
abstract: BACKGROUND
  This was a study of the relation of clinicopathological factors to prognosis in 25 patients who had ampullary carcinoma resected.
  
  
  METHODS
  The 5-year survival rate was six of the 25 patients. The presence of microperineural invasion was sought and related to outcome.
  
  
  RESULTS
  Factors relating to prognosis included tumour gross appearance, diameter, pancreatic invasion and microperineural invasion. The 5-year survival rate of 14 patients with microperineural invasion was 3, significantly worse than the 7 in 11 without invasion (P = 0.002, univariate analysis). By multivariate analysis, microperineural invasion was the most important prognostic factor (P = 0.02). Type of tumour recurrence was similar to that in pancreatic carcinoma.
  
  
  CONCLUSIONS
  Pancreaticoduodenectomy, rather than local resection, is the procedure of choice in patients with ampullary carcinoma.
authors.affiliation: First Department of Surgery, Kinki University School of Medicine, Osaka, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Nakai
authors.forename: K
authors.initials: K
authors.lastname: Koh
authors.forename: T
authors.initials: T
authors.lastname: Kawabe
authors.forename: E
authors.initials: E
authors.lastname: Son
authors.forename: H
authors.initials: H
authors.lastname: Yoshikawa
authors.forename: M
authors.initials: M
authors.lastname: Yasutomi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D014670:Ampulla of Vater; D003138:Common Bile Duct Neoplasms / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D016577:Pancreaticoduodenectomy / Q000401:mortality; D011379:Prognosis; D016019:Survival Analysis; D015996:Survival Rate