Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Jan 27;14(1):24-35.
doi: 10.4240/wjgs.v14.i1.24.

Survival after curative pancreaticoduodenectomy for ampullary adenocarcinoma in a South American population: A retrospective cohort study

Ramiro Manuel Fernandez-Placencia  1 , Paola Montenegro  2 , Melvy Guerrero  3 , Mariana Serrano  2 , Emperatriz Ortega  2 , Mercedes Bravo  3 , Lourdes Huanca  3 , Stéphane Bertani  4 , Juan Manuel Trejo  5 , Patricia Webb  3 , Jenny Malca-Vasquez  5 , Luis Taxa  3 , Alberto Lachos-Davila  5 , Juan Celis-Zapata  6 , Carlos Luque-Vasquez  7 , Eduardo Payet  7 , Eloy Ruiz  6 , Francisco Berrospi  6
Affiliations

Survival after curative pancreaticoduodenectomy for ampullary adenocarcinoma in a South American population: A retrospective cohort study

Ramiro Manuel Fernandez-Placencia et al. World J Gastrointest Surg. .

Abstract

Background: Ampullary adenocarcinoma (AAC) is a rare neoplasm that accounts for only 0.2% of all gastrointestinal cancers. Its incidence rate is lower than 6 cases per million people. Different prognostic factors have been described for AAC and are associated with a wide range of survival rates. However, these studies have been exclusively conducted in patients originating from Asian, European, and North American countries.

Aim: To evaluate the histopathologic predictors of overall survival (OS) in South American patients with AAC treated with curative pancreaticoduodenectomy (PD).

Methods: We analyzed retrospective data from 83 AAC patients who underwent curative (R0) PD at the National Cancer Institute of Peru between January 2010 and October 2020 to identify histopathologic predictors of OS.

Results: Sixty-nine percent of patients had developed intestinal-type AAC (69%), 23% had pancreatobiliary-type AAC, and 8% had other subtypes. Forty-one percent of patients were classified as Stage I, according to the AJCC 8th Edition. Recurrence occurred primarily in the liver (n = 8), peritoneum (n = 4), and lung (n = 4). Statistical analyses indicated that T3 tumour stage [hazard ratio (HR) of 6.4, 95% confidence interval (CI) of 2.5-16.3, P < 0.001], lymph node metastasis (HR: 4.5, 95%CI: 1.8-11.3, P = 0.001), and pancreatobiliary type (HR: 2.7, 95%CI: 1.2-6.2, P = 0.025) were independent predictors of OS.

Conclusion: Extended tumour stage (T3), pancreatobiliary type, and positive lymph node metastasis represent independent predictors of a lower OS rate in South American AAC patients who underwent curative PD.

Keywords: Adenocarcinoma; Ampulla; Gastrointestinal neoplasms; Pancreaticoduodenectomy; South America; Survival.

PubMed Disclaimer

Conflict of interest statement

Conflict-of-interest statement: No conflicts of interest to be declared.

Figures

Figure 1
Figure 1
Survival probability of patients with adenocarcinoma of the ampulla of Vater undergoing pancreaticoduodenectomy.
Figure 2
Figure 2
Comparison of survival probability between the intestinal/other (A) and pancreaticobiliary (B) types in patients with pT3 and pN+ adenocarcinoma of the ampulla of Vater.
See this image and copyright information in PMC

References

    1. Askew J, Connor S. Review of the investigation and surgical management of resectable ampullary adenocarcinoma. HPB (Oxford) 2013;15:829–838. - PMC - PubMed
    1. O'Connell JB, Maggard MA, Manunga J Jr, Tomlinson JS, Reber HA, Ko CY, Hines OJ. Survival after resection of ampullary carcinoma: a national population-based study. Ann Surg Oncol. 2008;15:1820–1827. - PubMed
    1. Cameron JL, He J. Two thousand consecutive pancreaticoduodenectomies. J Am Coll Surg. 2015;220:530–536. - PubMed
    1. Chandrasegaram MD, Chiam SC, Chen JW, Khalid A, Mittinty ML, Neo EL, Tan CP, Dolan PM, Brooke-Smith ME, Kanhere H, Worthley CS. Distribution and pathological features of pancreatic, ampullary, biliary and duodenal cancers resected with pancreaticoduodenectomy. World J Surg Oncol. 2015;13:85. - PMC - PubMed
    1. Sommerville CAM, Limongelli P, Pai M. Survival analysis after pancreatic resection for ampullary and pancreatic head carcinoma: An analysis of clinicopathological factors. J Surg Oncol . 2009;100:651–656. - PubMed