Presentation, treatment and outcome in patients with ampullary tumours

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: Ov...

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Bibliographic Details
Published in:British journal of surgery 2004-12, Vol.91 (12), p.1600-1607
Main Authors: Bettschart, V., Rahman, M. Q., Engelken, F. J. F., Madhavan, K. K., Parks, R. W., Garden, O. J.
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Ampulla of Vater - pathology
Ampulla of Vater - surgery
Biological and medical sciences
Common Bile Duct Neoplasms - pathology
Common Bile Duct Neoplasms - surgery
Female
General aspects
Humans
Male
Medical sciences
Middle Aged
Prospective Studies
Risk Factors
Survival Analysis
Treatment Outcome
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Summary: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. Copyright © 2004 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. Aggressive surgery is justified
ISSN:0007-1323
1365-2168
DOI:10.1002/bjs.4787