title: Survival analysis after pancreatic resection for ampullary and pancreatic head carcinoma: an analysis of clinicopathological factors.
abstract: OBJECTIVE
  Surgery remains the only curative option for the treatment of pancreatic and ampullary carcinomas. To examine the survival differences between ampullary and pancreatic head carcinomas after pancreaticoduodenectomy.
  
  
  METHODS
  A retrospective review of patients with ampullary or pancreatic head adenocarcinoma undergoing curative resection during a 6-year period prior to 2000.
  
  
  RESULTS
  A total of 104 patients underwent pancreaticoduodenectomy for pancreatic head and ampullary carcinomas (n = 65 and n = 39, respectively). Histologically, pancreatic cancer was worse, with more lymph node involvement and more positive resection margins and vascular and perineural invasions than found in ampullary carcinoma. The median disease-free and overall survival rates were significantly better for ampullary cancer when compared with pancreatic cancer (17 vs. 9 months [P = 0.001] and 35 vs. 24 months [P = 0.006], respectively). The actuarial 5-year disease-free and overall survival rates were 4.4% and 10.5%, respectively, for pancreatic carcinoma and 27.9% and 31.8%, respectively, for ampullary carcinoma. Multivariate analysis showed that microscopic resection margin involvement (P = 0.02) and involvement of over three nodes (P < 0.001) were significant factors affecting the overall survival for pancreatic and ampullary carcinomas, respectively.
  
  
  CONCLUSIONS
  In this study, patients with ampullary carcinoma have a better prognosis and survival than those with pancreatic carcinoma.
authors.affiliation: Division of Surgery and Cancer, HPB Unit, Hammersmith Hospital, Imperial College, London, England.
authors.forename: C A M
authors.initials: CA
authors.lastname: Sommerville
authors.forename: P
authors.initials: P
authors.lastname: Limongelli
authors.forename: M
authors.initials: M
authors.lastname: Pai
authors.forename: R
authors.initials: R
authors.lastname: Ahmad
authors.forename: G
authors.initials: G
authors.lastname: Stamp
authors.forename: N A
authors.initials: NA
authors.lastname: Habib
authors.forename: R C N
authors.initials: RC
authors.lastname: Williamson
authors.forename: L R
authors.initials: LR
authors.lastname: Jiao
mesh_terms: D000328:Adult; D000368:Aged; D014670:Ampulla of Vater; D003138:Common Bile Duct Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D016577:Pancreaticoduodenectomy