Abstract
The prognostic factors for patients with ampullary cancer were examined, and the possibility of indications for limited surgery was investigated. The clinicopathological factors of 80 resected cases are analyzed, and moreover, five patients who underwent PHRSD for pT1 cancer were compared with 11 patients who underwent pancreatoduodenectomy (PD). Multivariate analyses of the resected cases revealed that positive histopathological lymph node metastasis was an independent prognostic factor. Analyses of preoperative factors revealed that a macroscopic appearance of the tumor other than the superficial protruding type, positive macroscopic pancreatic invasion, and positive macroscopic duodenal invasion were significantly correlated with positive histopathological lymph node metastasis. In patients who underwent PHRSD, the operation time and associated blood loss were comparable with those of PD, and neither recurrence nor death from cancer was found. However, given the insufficient accuracy rate of the imaging diagnostic techniques, PD should be considered as the standard operation for ampullary cancer, even for T1 cases, at the present time.
