Implications of Histological Grade of Tumour for the Prognosis of Radically Resected Periampullary Adenocarcinoma

• Published in: The European journal of surgery 1999, Vol.165 (9), p.865-870
• Main Authors: Sellner, Franz J., Riegler, Franz M., Machacek, Ernst
• Format: Article
• Language: English
• ISSN: 1102-4151; 1741-9271
• DOI: 10.3109/11024159950189375

Objective: To study the influence of histological grade of tumour on the prognosis of radically resected periampullary cancers. Design: Retrospective study. Setting: Teaching hospital, Austria Subjects: 156 patients (papilla of Vater, n ≥ 34, head of the pancreas, n ≥ 105, and distal common bile duct, n ≥ 17) who underwent partial pancreaticoduodenectomy for periampullary adenocarcinoma between 1 January, 1967 and 31 December, 1996. Outcome measures: The relation between grade of tumour and site, T and N classification, extramural growth, invasion of vessels and resection margins, tumour volume, and survival time. Results: Well differentiated lesions were significantly more common in the papilla of Vater (n ≥ 15, 44%, p ≥ 0.01) than in the pancreatic head or the common bile duct (n ≥ 20, 19%, and n ≥ 5, 29%, respectively). Only in ampullary lesions did the grade of tumour significantly affect the incidence of other histopathological risk factors (T p ≥ 0.003; nodal status p ≥ 0.01; extramural growth p ≥ 0.0001; tumour volume p ≥ 0.02) and survival time (p ≥ 0.02); no significant correlations were found in cancers of the head of the pancreas or common bile duct. Conclusions: There was a significant difference in the distribution of grade of tumour between the different sites of origin of resected periampullary cancers. Grade of tumour correlated with T and N classification, tumour volume, extramural growth, and survival only in ampullary lesions.