Five-Year Survival and Prognostic Factors of Patients with Periampullary Carcinoma Who Underwent Pancreaticoduodenectomy
Keywords:
Periampullary carcinoma, Pancreaticoduodenectomy, Survival rateAbstract
Objective: Periampullary carcinomas are defined as tumors that arise within 2 cm of the major papilla. The pancreaticoduodenectomy is the standard curative treatment for these tumors. However, the long-term survival may vary due to many factors. This study aimed to identify prognostic factors and 5-year survival of periampullary carcinoma; and to evaluate the surgical outcomes of a pancreaticoduodenectomy.
Patients and Methods: We conducted a retrospective review of the medical records of patients with periampullary carcinoma who underwent pancreaticoduodenectomy from January 2010 to December 2014 in a tertiary hospital. Patient characteristics, perioperative data and pathological data were analyzed. Univariate and multivariate analysis of prognostic factors for survival was analyzed by the Cox proportional hazard model. The Kaplan-Meier survival curve was used to describe survival rate. The P-value less than 0.05 was considered as statistically significant.
Results: Of 61 patients (with a median age of 58 years), cancer of the ampulla of Vater was the most common tumor. The 3-year and 5-year overall survival rates were 52.5% and 34.4%, respectively. The 30-day postoperative mortality rate was 4.9%. Median overall survival time is 37.4 months. The independent prognostic factors were lymphovascular invasion (hazard ratio (HR): 9.10, 95% confidence interval (95% CI): 2.51 to 32.96, p = < 0.001) and moderate or poor tumor differentiation (HR: 2.28, 95% CI: 1.08 to 4.84, p = 0.03).
Conclusion: In this study, the 5-year overall survival rate was 34.4%. Poor prognostic factors of periampullary carcinoma after pancreaticoduodenectomy included the presence of lymphovascular invasion and poor to moderate tumor differentiation.
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