Carcinoma of periampullary region; histopathological study and correlation with prognosis

ABSTRACT

Periampullary malignancies are aggressive neoplasms with low survival rates. The factors favoring long-term survival for periampullary neoplasm are related to histopathologic features, site, stage, resection margins and lymph node metastases. To study some clinical and histopathological parameters of cancer head of pancreas and periampullary region. Statistical study of the impact of these parameters on the outcome of malignancy in this region. This study was carried out on 144 cases of penampullary cancers. The clinical data including, pathological data are revised. Special stains and immunohistochemistry are used when necessary. The most common malignant tumor of peniampullary region is carcinoma of ampulla of vater, then cancer head pancreas, then bile duct carcinoma and lastly duodenal carcinoma [43.7%, 40%, 10% and 6.3% respectively]. We found that the median survival of periampullary cancer is 15 months. The prognosis of these malignant tumors is related to site [P=0.0054], size of the tumor [P=0.0005], grade [P=0.0000], lymph node metastasis [P=0.0123] and tumor stage [P=0.0084]. Other parameters including age and sex, local extension and cut margins are statistically of no significant effects on the prognosis. Periampullary carcinomas are aggressive neoplasm with short survival. It seems that our locality shows epidemiologic factors that leads to that the age of patients at time of presentation and prognosis differ from literatures