[Number of lymph node metastases: a significant prognostic factor for patients with radical resection of carcinoma of the ampulla of Vater].
OBJECTIVE
To identify prognostic factors predicting survival after radical resection of ampullary carcinoma.


METHODS
Clinical data of sixty- five patients with cancer of the ampulla of Vater underwent pancreaticoduodenectomy and regional lymphadenectomy were analyzed retrospectively.


RESULTS
A total of 1380 lymph nodes dissected from the resected specimens was examined to detect the presence of metastasis. The median follow- up period was 83 months. Univariate analysis revealed that factors associated with poor survival included the number and the location of positive nodes. Thirty- three of the 65 patients had a total of 116 positive lymph nodes, of whom 20 had 1- 3 positive regional nodes lymph and 13 had > or = 4 positive regional lymph nodes. Multivariate analysis revealed that the number of positive nodes lymph was an independent prognostic factor (P=0.007), while the locations of lymph nodes failed to remain as an independent variable. The survival rate in patients with > or = 4 positive lymph nodes was significantly lower than that in those with 1- 3 positive lymph nodes. The median survival time was 49 months with a 5- year survival rate of 43% in patients with 1- 3 positive lymph nodes, whereas all patients with > or = 4 positive nodes died of the disease within 23 months after resection (P=0.0001).


CONCLUSIONS
The number of positive regional lymph nodes is an independent prognostic factor in patients with ampullary carcinoma after resection.
Liu
Ning
N
Department of Gastrointestinal Surgery, Affiliated Cancer Hospital, Tianjin Medical University, Tianjin 300060, China. liuning001@sina.com
Liang
Han
H
Zhang
Ru-peng
RP
Pan
Yuan
Y
Liu
Yong
Y
Deng
Jing-yu
JY
Wang
Xiao-na
XN
Ding
Xue-wei
XW
Hao
Xi-shan
XS
D000328:Adult; D000368:Aged; D014670:Ampulla of Vater / Q000473:pathology*; D002277:Carcinoma / Q000473:pathology; D003138:Common Bile Duct Neoplasms / Q000473:pathology*; D004379:Duodenal Neoplasms / Q000175:diagnosis* / Q000556:secondary; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011184:Postoperative Period; D011379:Prognosis; D012189:Retrospective Studies