[Clinical significance of solitary lymph node metastasis in carcinoma of the ampulla of Vater].
OBJECTIVE
To investigate the rule of distribution of solitary lymph node metastasis and its relation with clinico-pathologic factors in carcinoma of ampulla of Vater.


METHODS
The data of 26 patients who were discovered to have solitary lymph node metastasis, from 152 patients with carcinoma of the ampulla of Vater who had received pancreatoduodenectomy were retrospectively reviewed. The related clinico-pathologic factors affecting it's metastasis were analyzed and compared with 105 such patients without any lymph node metastasis.


RESULTS
Of these 152 patients with carcinoma of ampulla of Vater, 47(30. 9%) had lymph node metastasis and 26 had only solitary lymph node metastasis with a rate of solitary lymph node metastasis of 55. 3% (26/47). The majority of the solitary lymph node metastasis (84. 6% , 22/26) were located at the pancreaticoduodenal region, only 4 patients had skip metastasis. It was revealed by Chi-square test (chi(2) ) that solitary lymph node metastasis was correlated with the tumor size (P = 0. 007) , histological differentiation(P = 0. 003) , T stage(P = 0. 000) and pancreatic infiltration (P =0. 009).


CONCLUSIONS
The majority of solitary lymph node metastasis are located at the pancreaticoduodenal region. Sentinel lymph node assessment may be helpful to determine the extent of lymph node dissection for carcinoma of the ampulla of Vater.
Shan
Yi
Y
Department of Abdominal Surgical Oncology, Cancer Hospital (Institute), Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100021, China.
Zhao
Dong-bing
DB
Che
Xu
X
Wang
Jian-xiong
JX
Shao
Yong-fu
YF
Zhao
Ping
P
D000230:Adenocarcinoma / Q000473:pathology* / Q000601:surgery; D000328:Adult; D000368:Aged; D014670:Ampulla of Vater; D003138:Common Bile Duct Neoplasms / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D010190:Pancreatic Neoplasms / Q000473:pathology; D016577:Pancreaticoduodenectomy; D012189:Retrospective Studies; D021701:Sentinel Lymph Node Biopsy