Significance analysis of histologic type and perineural invasion as prognostic factors after curative resection of ampulla of Vater carcinoma.
OBJECTIVE
Periampullary adenocarcinoma has either intestinal- or pancreatobiliary-type of differentiation. These types and perineural invasion have been shown to have prognostic relevance. The influences of histologic type and perineural invasion on recurrence and survival in ampullar of Vater carcinoma still need to be assessed.


METHODS
We reviewed and analyzed the clinicopathologic data, surgical outcomes, recurrence and survival of 49 patients who received curative pancreatoduodenectomy for ampulla of Vater carcinoma at Hanyang University Hospital between July 1994 and June 2008.


RESULTS
Twenty patients experienced recurrence, and the 5-year overall survival rates were 53.1%. Perineural invasion as well as tumor grade, T stage, lymph node metastasis, and lymphatic invasion were associated with survival (p < 0.05). The group positive for perineural invasion had a high recurrence rate (56.5% versus 28.0%) and a low 5-year survival (39.1% versus 68.0%) compared to those of the negative group. Pancreatobililary-type had a higher recurrence rate (58.3% versus 36.1%) and a lower 5-year survival rate (33.3% versus 61.1%) in comparison to intestinal-type. However, histologic type was not a statistically significant factor (p > 0.1).


CONCLUSIONS
Perineural invasion is a significant factor for survival. Histologic type has no significance as a prognostic factor despite differences between the two subgroups.
Lee
Jae Hoon
JH
Department of Surgery, College of Medicine, Hanyang University, 17 Haengdang-dong, Seongdong-gu, Seoul 133-791, Korea.
Lee
Kyeong Geun
KG
Ryou
Hyunchul
H
Jun
Young Jin
YJ
Paik
Seung Sam
SS
Park
Hwon Kyum
HK
Lee
Kwang Soo
KS
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014670:Ampulla of Vater / Q000473:pathology*; D003138:Common Bile Duct Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local; D010525:Peripheral Nerves / Q000473:pathology*; D011379:Prognosis; D015996:Survival Rate