title: Impact of lymph node metastasis on survival in patients with pathological T1 carcinoma of the ampulla of Vater.
abstract: To determine the prognostic factors for patients with pathological T1 (pT1) carcinoma of the ampulla of Vater, 36 consecutive patients with carcinoma of the ampulla of Vater who underwent surgery were retrospectively analyzed in terms of clinicopathological features. The overall 5-year Kaplan-Meier survival in all patients was 50.2%, and the median survival of all patients was 64.0 months. Factors favorably influencing a long-term outcome were the absence of lymph node metastasis (P < 0.0001), the absence of ulcer formation of the tumor (P = 0.0062), and the absence of tumor invasion into the duodenum (P = 0.0025) and the pancreas (P = 0.0098). In a multivariate analysis, lymph node metastasis was the only predictor of survival (P = 0.0023). In the pT1 stage patients, 20% of the patients had lymph node metastasis, and their survival was statistically poor compared to the pT1 patients without lymph node metastasis (P = 0.017). As for survival after the operation, there was no significant difference between pancreatoduodenectomy and pylorus-preserving pancreatoduodenectomy.
authors.affiliation: Second Department of Surgery, Wakayama Medical University, Wakayama, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Terasawa
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Uchiyama
authors.forename: Masaji
authors.initials: M
authors.lastname: Tani
authors.forename: Manabu
authors.initials: M
authors.lastname: Kawai
authors.forename: Takeshi
authors.initials: T
authors.lastname: Tsuji
authors.forename: Katsuyoshi
authors.initials: K
authors.lastname: Tabuse
authors.forename: Yasuhito
authors.initials: Y
authors.lastname: Kobayashi
authors.forename: Katsutoshi
authors.initials: K
authors.lastname: Taniguchi
authors.forename: Hiroki
authors.initials: H
authors.lastname: Yamaue
mesh_terms: D000368:Aged; D014670:Ampulla of Vater; D017024:Chemotherapy, Adjuvant; D003138:Common Bile Duct Neoplasms / Q000188:drug therapy / Q000401:mortality* / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D016019:Survival Analysis