A survival predictive model in patients undergoing radical resection of ampullary adenocarcinoma.
OBJECTIVE
Radical resection with either pancreaticoduodenectomy or pylorus-preserving pancreaticoduodenectomy is considered to be the standard treatment for most ampullary carcinomas, but the prognostic predictive model has not yet been developed.


METHODS
The pretreatment, treatment, and follow-up variables of data of 47 patients undergoing radical resection for the ampullary carcinoma were analyzed to determine the favorable prognostic variables. Employing the Kaplan-Meier method, the cumulative survival rates of the ampullary carcinoma were calculated. By Cox regression model, a stepwise multivariate analysis was performed to analyze the contributing factors of the survival rate, and a predictive survival equation was obtained.


RESULTS
With the results of the univariate analysis, the variables significantly associated with favorable prognosis were younger age (<63 years), TNM stage (stage I or II or III), and the degree of tumor differentiation (well or moderately differentiated). When the above three variables were examined as covariates by Cox regression in multivariate analysis, the TNM stage and the degree of tumor differentiation were independently correlated with the survival. A predictive survival equation obtained with the beta-coefficients of the above three variables was as follows: S (t) = [So (t)] P, P = exp (0.0234 x age - 1.8744 x tumor differentiation + 1.1576 x TNM stage)


CONCLUSIONS
This predictive survival equation can predict the survival and the favorable outcome of patients treated with radical resection of ampullary carcinoma.
Wang
Chun-Hsiang
CH
Department of Internal Medicine, Tainan Municipal Hospital, Tainan, Taiwan. chwang@mail.tmh.org.tw
Mo
Lein-Ray
LR
Lin
Ruey-Chang
RC
Kuo
Jen-Juan
JJ
Chang
Kuo-Kwan
KK
Lin
Yi-Wen
YW
Yang
Da-Ming
DM
Yau
Man-Pun
MP
Cho
Chi-Yu
CY
D000206:Actuarial Analysis; D000230:Adenocarcinoma / Q000401:mortality / Q000601:surgery*; D000368:Aged; D014670:Ampulla of Vater / Q000601:surgery*; D000704:Analysis of Variance; D001663:Bilirubin / Q000097:blood; D002471:Cell Transformation, Neoplastic / Q000473:pathology; D003138:Common Bile Duct Neoplasms / Q000401:mortality / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008111:Liver Function Tests; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D009367:Neoplasm Staging; D016577:Pancreaticoduodenectomy / Q000379:methods*; D011183:Postoperative Complications / Q000401:mortality*; D011379:Prognosis; D011706:Pyloric Antrum / Q000601:surgery; D012044:Regression Analysis; D016019:Survival Analysis
D001663:Bilirubin