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Importance of microperineural invasion as a prognostic factor in ampullary carcinoma
1First Department of Surgery, Kinki University School of Medicine, Osaka, Japan.
Background:
This was a study of the relation of clinicopathological factors to prognosis in 25 patients who had ampullary carcinoma resected.
Methods:
The 5-year survival rate was six of the 25 patients. The presence of microperineural invasion was sought and related to outcome.
Results:
Factors relating to prognosis included tumour gross appearance, diameter, pancreatic invasion and microperineural invasion. The 5-year survival rate of 14 patients with microperineural invasion was 3, significantly worse than the 7 in 11 without invasion (P = 0.002, univariate analysis). By multivariate analysis, microperineural invasion was the most important prognostic factor (P = 0.02). Type of tumour recurrence was similar to that in pancreatic carcinoma.
Conclusion:
Pancreaticoduodenectomy, rather than local resection, is the procedure of choice in patients with ampullary carcinoma.