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Adenocarcinoma of the ampulla of Vater: predictors of survival and recurrence after curative radical resection

BACKGROUNDS/AIMS: Because of low incidence rates, there have been few reports on the patterns of and risk factors for recurrence after curative resection of the ampulla of Vater (AoV) cancer. The aim of this study was to characterize patterns of recurrence and to evaluate risk factors affecting surv...

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Autores principales: Kim, Kang Jae, Choi, Dong Wook, Kim, Woo Seok, Kim, Min Jung, Song, Sun Choon, Heo, Jin Seok, Choi, Seong Ho
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Association of Hepato-Biliary-Pancreatic Surgery 2011
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4582543/
https://www.ncbi.nlm.nih.gov/pubmed/26421035
http://dx.doi.org/10.14701/kjhbps.2011.15.3.171
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author Kim, Kang Jae
Choi, Dong Wook
Kim, Woo Seok
Kim, Min Jung
Song, Sun Choon
Heo, Jin Seok
Choi, Seong Ho
author_facet Kim, Kang Jae
Choi, Dong Wook
Kim, Woo Seok
Kim, Min Jung
Song, Sun Choon
Heo, Jin Seok
Choi, Seong Ho
author_sort Kim, Kang Jae
collection PubMed
description BACKGROUNDS/AIMS: Because of low incidence rates, there have been few reports on the patterns of and risk factors for recurrence after curative resection of the ampulla of Vater (AoV) cancer. The aim of this study was to characterize patterns of recurrence and to evaluate risk factors affecting survival rates and recurrence after curative resection. METHODS: Medical records of 181 patients who had undergone pancreaticoduodenectomy with curative intent for AoV adenocarcinoma between December 1994 and March 2010 at Samsung Medical Center were retrospectively reviewed. Factors influencing on overall survival rate, recurrence rates, and recurrence patterns were analyzed. RESULTS: Lymph node metastases and high preoperative serum carcinoembryonic antigen (CEA) level >5 ng/ml were identified as independent factors affecting overall survival (p=0.006, p<0.001, respectively). Among the 181 patients, 69 developed local or distant recurrence within 3 years after curative resection. Lymph node metastasis, preoperative serum CEA level >5 ng/ml, and total bilirubin level >1.5 mg/dl were identified as independent prognostic factors of recurrence after curative resection (p=0.008, p<0.001, p=0.003, respectively). CONCLUSIONS: AoV adenocarcinoma has a better prognosis than other periampullary carcinomas, but still has a high recurrence rate, especially during the first three years after curative radical resection. Therefore, careful follow-up is needed during the first 3 years, especially for the higher risk group. Further study of adjuvant therapy to decrease recurrence after curative resection is now warranted.
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spelling pubmed-45825432015-09-29 Adenocarcinoma of the ampulla of Vater: predictors of survival and recurrence after curative radical resection Kim, Kang Jae Choi, Dong Wook Kim, Woo Seok Kim, Min Jung Song, Sun Choon Heo, Jin Seok Choi, Seong Ho Korean J Hepatobiliary Pancreat Surg Original Article BACKGROUNDS/AIMS: Because of low incidence rates, there have been few reports on the patterns of and risk factors for recurrence after curative resection of the ampulla of Vater (AoV) cancer. The aim of this study was to characterize patterns of recurrence and to evaluate risk factors affecting survival rates and recurrence after curative resection. METHODS: Medical records of 181 patients who had undergone pancreaticoduodenectomy with curative intent for AoV adenocarcinoma between December 1994 and March 2010 at Samsung Medical Center were retrospectively reviewed. Factors influencing on overall survival rate, recurrence rates, and recurrence patterns were analyzed. RESULTS: Lymph node metastases and high preoperative serum carcinoembryonic antigen (CEA) level >5 ng/ml were identified as independent factors affecting overall survival (p=0.006, p<0.001, respectively). Among the 181 patients, 69 developed local or distant recurrence within 3 years after curative resection. Lymph node metastasis, preoperative serum CEA level >5 ng/ml, and total bilirubin level >1.5 mg/dl were identified as independent prognostic factors of recurrence after curative resection (p=0.008, p<0.001, p=0.003, respectively). CONCLUSIONS: AoV adenocarcinoma has a better prognosis than other periampullary carcinomas, but still has a high recurrence rate, especially during the first three years after curative radical resection. Therefore, careful follow-up is needed during the first 3 years, especially for the higher risk group. Further study of adjuvant therapy to decrease recurrence after curative resection is now warranted. Korean Association of Hepato-Biliary-Pancreatic Surgery 2011-08 2011-08-31 /pmc/articles/PMC4582543/ /pubmed/26421035 http://dx.doi.org/10.14701/kjhbps.2011.15.3.171 Text en Copyright © 2011 by The Korean Association of Hepato-Biliary-Pancreatic Surgery http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Kim, Kang Jae
Choi, Dong Wook
Kim, Woo Seok
Kim, Min Jung
Song, Sun Choon
Heo, Jin Seok
Choi, Seong Ho
Adenocarcinoma of the ampulla of Vater: predictors of survival and recurrence after curative radical resection
title Adenocarcinoma of the ampulla of Vater: predictors of survival and recurrence after curative radical resection
title_full Adenocarcinoma of the ampulla of Vater: predictors of survival and recurrence after curative radical resection
title_fullStr Adenocarcinoma of the ampulla of Vater: predictors of survival and recurrence after curative radical resection
title_full_unstemmed Adenocarcinoma of the ampulla of Vater: predictors of survival and recurrence after curative radical resection
title_short Adenocarcinoma of the ampulla of Vater: predictors of survival and recurrence after curative radical resection
title_sort adenocarcinoma of the ampulla of vater: predictors of survival and recurrence after curative radical resection
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4582543/
https://www.ncbi.nlm.nih.gov/pubmed/26421035
http://dx.doi.org/10.14701/kjhbps.2011.15.3.171
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