Affiliation:
1. Department of Surgery, Sherbrooke University, Sherbrooke, Quebec, Canada
2. Department of Clinical and Surgical Sciences (Surgery), Royal Infirmary of Edinburgh, Edinburgh, UK
Abstract
Abstract
Background
Ampullary tumours are relatively rare, and few large single-centre reports provide information on their treatment and outcome. The aim of this study was to analyse outcome and determine predictors of survival for patients with ampullary tumours treated in a specialist centre.
Methods
Over an 11-year period, 561 patients were treated for periampullary tumours, 88 of whom had a histologically proven ampullary neoplasm. Prospectively gathered data were analysed to assess predictors of survival.
Results
The overall resection rate was 92 per cent; there were no postoperative deaths. Median survival was 45·8 months for patients with resectable tumours and 8·0 months for those with irresectable disease (P < 0·001). On univariate analysis, age less than 70 years (P = 0·015) and a bilirubin level of 75 µmol/l or less (P = 0·012) favoured long-term survival. Among 70 patients who underwent cancer resection, factors associated with significantly worse long-term survival on univariate analysis included poorly differentiated tumour (P < 0·001), positive nodes (P < 0·001), perineural invasion (P = 0·001) and invasion of the pancreas (P = 0·018). Multivariate analysis identified positive nodes and bilirubin concentration as independent predictors of survival.
Conclusion
An aggressive surgical approach to ampullary tumours is justified by the low proportion of benign lesions, the absence of postoperative mortality and improved long-term survival.
Funder
Sicpa, Foundation, Prilly, Switzerland and Fondation du 450ème Anniversaire de l'Université de Lausanne, Lausanne, Switzerland
Publisher
Oxford University Press (OUP)
Cited by
54 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献