title: Long-term outcome of surgical treatment for ampullary carcinoma.
abstract: OBJECTIVE
  We aimed to clarify the surgical indication and describe the long-term surgical outcome for ampullary carcinoma.
  
  
  METHODS
  The long-term outcomes of 23 patients who underwent pancreaticoduodenectomy were retrospectively reviewed. The prognostic factors for cancer-specific survival and overall survival after surgery were investigated.
  
  
  RESULTS
  The cancer-specific 5-, 10- and 20-year survival rates after resection of the ampullary carcinoma were 52%, 43% and 43%, respectively, while the corresponding overall survival rates were 52%, 32% and 24%, respectively. Ten of the 11 patients with recurrent ampullary carcinoma died within 5 years after surgery. Four patients died because of pancreatic cancer, colon cancer, old age after curative resection of gastric cancer, and pneumonia at later than 5 years after the surgery. The risk factors for the short cancer-specific survival period were pancreatic invasion and lymph node metastasis, while those for the short overall survival period were pancreatic invasion and the tumor grade.
  
  
  CONCLUSIONS
  Our study indicates that recurrence of ampullary carcinoma within 5 years after its resection, especially in patients with pancreatic invasion or lymph node metastasis and development of other diseases after more than 5 years after the surgery should be carefully investigated.
authors.affiliation: Department of Hepato-Biliary-Pancreatic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan. m1297198@msic.med.osaka-cu.ac.jp
authors.forename: Hiroji
authors.initials: H
authors.lastname: Shinkawa
authors.forename: Shigekazu
authors.initials: S
authors.lastname: Takemura
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kiyota
authors.forename: Takahiro
authors.initials: T
authors.lastname: Uenishi
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Kaneda
authors.forename: Masayuki
authors.initials: M
authors.lastname: Sakae
authors.forename: Yorihisa
authors.initials: Y
authors.lastname: Urata
authors.forename: Kazunori
authors.initials: K
authors.lastname: Ohata
authors.forename: Akinori
authors.initials: A
authors.lastname: Nozawa
authors.forename: Shoji
authors.initials: S
authors.lastname: Kubo
mesh_terms: D000368:Aged; D014670:Ampulla of Vater / Q000601:surgery*; D003138:Common Bile Duct Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D016577:Pancreaticoduodenectomy; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome