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Evaluation of Surgical Resection for Ampullar Carcinoma at Japanese Single Cancer Institute

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Title: Evaluation of Surgical Resection for Ampullar Carcinoma at Japanese Single Cancer Institute
Authors: Nanashima, Atsushi / Tobinaga, Syuuichi / Abo, Takafumi / Ohnita, Ken / Norimura, Daisuke / Yajima, Hiroyuki / Takeshita, Hiroaki / Onaka, Takashi / Hidaka, Shigekazu / Takeshima, Fuminao / Yamaguchi, Naoyuki / Isomoto, Hajime / Sawai, Terumitsu / Nakao, Kazuhiko / Nagayasu, Takeshi
Issue Date: Aug-2010
Publisher: Nagasaki University School of Medicine / 長崎大学医学部
Citation: Acta Medica Nagasakiensia, 55(1), pp.23-28; 2010
Abstract: Surgical resection is the only radical treatment option for duodenal ampullar carcinoma (AC) that results in an improved patient prognosis. Method: We examined the demographics, surgical records, and outcome in 23 patients with AC undergoing pancreaticoduodenectomy (PD). Results: Of 23 patients, 17 underwent pylorus preserving PD (PPPD) and 6 underwent PD, including subtotal stomach-preserving PD in 5. D2 lymphadenectomy was performed in 17 patients and D3 lymphadenectomy was performed in 6. The combined resection of the superior mesenteric vein was performed in 1 patient. Postoperative cancer recurrence was observed in 32%, and 6 patients died of cancer. The 3-year tumor-free survival rates were not different between the final stages (p=0.64) and the 5-year cancer-related overall survival rates were not different between stages either (p=0.28). Tumor size?3cm resulted in significantly poorer survival rate compared to smaller tumors (p=0.032). Node metastasis at Group 2, and moderately or poorly differentiated adenocarcinoma were significantly associated with poor survival (p<0.05); however, cancer infiltration at cut-end margin, degree of node dissection and curability were not associated with overall prognosis. Conclusions: Radical surgical resection showed good patient prognosis; however, new adjuvant chemotherapy is a promising modality to improve patient survival in AC patients with poor prognostic factors.
Keywords: Ampullar carcinoma / Pancreaticoduodenectomy / Radical operation
URI: http://hdl.handle.net/10069/24158
ISSN: 00016055
Type: Departmental Bulletin Paper
Text Version: publisher
Appears in Collections:Volume 55, No. 1

Citable URI : http://hdl.handle.net/10069/24158

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