title: Survival and prognostic factors in pancreatic and ampullary cancer.
abstract: OBJECTIVE
  We analyzed survival of patients diagnosed with ampullary cancer (AC) and pancreatic ductal adenocarcinomas (PDAC).
  
  
  METHODS
  Between 1996 and 2009, 505 and 69 patients diagnosed with PDAC and AC, respectively, were identified. Overall survival was analyzed according to tumor entity, therapeutic approach and pathological tumor stage.
  
  
  RESULTS
  The 5-year overall survival rate of patients with AC (37%; 95% confidence interval 25-49%) was remarkably higher compared to PDAC patients (7%; 95% confidence interval 5-10%). In both cohorts, surgical resection improved survival. Analysis of pathological factors revealed a survival benefit for patients staged with small primary tumors (pT1/2) and exclusion of distant metastases (M0) for both PDAC and AC. Interestingly, absence of lymph node metastasis substantially improved survival in AC, but not in PDAC.
  
  
  CONCLUSIONS
  Overall survival of patients with AC is superior compared to that of patients with PDAC. Therapeutically, adequate regional lymph node dissection seems particularly important for the surgical management of AC.
authors.affiliation: Clinic of General and Visceral Surgery, University of Ulm, Ulm, Germany.
authors.forename: Johannes
authors.initials: J
authors.lastname: Lemke
authors.affiliation: Clinic of General and Visceral Surgery, University of Ulm, Ulm, Germany.
authors.forename: Désirée
authors.initials: D
authors.lastname: Schäfer
authors.affiliation: Institute of Epidemiology and Medical Biometry, University of Ulm, Ulm, Germany.
authors.forename: Silvia
authors.initials: S
authors.lastname: Sander
authors.affiliation: Clinic of General and Visceral Surgery, University of Ulm, Ulm, Germany.
authors.forename: Doris
authors.initials: D
authors.lastname: Henne-Bruns
authors.affiliation: Clinic of General and Visceral Surgery, University of Ulm, Ulm, Germany marko.kornmann@uniklinik-ulm.de.
authors.forename: Marko
authors.initials: M
authors.lastname: Kornmann
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000556:secondary / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014670:Ampulla of Vater / Q000473:pathology* / Q000601:surgery; D021441:Carcinoma, Pancreatic Ductal / Q000401:mortality / Q000556:secondary / Q000601:surgery; D003138:Common Bile Duct Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D010190:Pancreatic Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D011379:Prognosis; D015996:Survival Rate; D055815:Young Adult
keywords: Pancreatic cancer; ampullary cancer; ampullary carcinoma; pancreatic ductal adenocarcinoma; prognosis; survival