The Outcomes of Curative Resection for Ampulla of Vater Cancer

ABSTRACT

INTRODUCTION: The prognosis of peri-ampullary cancer is poor because of its low respectability and high recurrence rate. Yet cancer of the Ampulla of Vater(AOV) has a relatively good prognosis. The aim of this study is to investigate the outcomes and to determine the factors that affect the survival rate of patients who underwent curative resection for AOV cancer. METHODS: From August 1988 to January 2008, 54 patients underwent curative resection for AOV cancer. We retrospectively reviewed the clinocopathologic data. The median follow up period was 45 months. RESULTS: Twenty-seven pancreaticoduodenectomies (PD) and 27 pyrolus-preserving pancreaticoduodenectomies (PPPD) were performed. There was no hospital mortality, but 25 out of 54 patients (47.3%) experienced postoperative complications. The 5-year overall survival (OS) rate was 53.97% and the 5-year disease free survival (DFS) rate was 51.75%. On multivariate analysis, the variables that affected the overall survival rate and the disease free survival rate was poor histologic differentiation (p<0.001). CONCLUSIONS: Although the AOV cancer is one of the periampullary cancers that have a very poor outcome, long-term survival and favorable outcomes can be achieved after a curative resection. In this study, poor-histologic differentiation was the only independent factor for a poor prognosis.