Clinic of General and Visceral Surgery, University of Ulm, Ulm, Germany.
Institute of Epidemiology and Medical Biometry, University of Ulm, Ulm, Germany.
Anticancer Res. 2014 Jun;34(6):3011-20.
We analyzed survival of patients diagnosed with ampullary cancer (AC) and pancreatic ductal adenocarcinomas (PDAC).
Between 1996 and 2009, 505 and 69 patients diagnosed with PDAC and AC, respectively, were identified. Overall survival was analyzed according to tumor entity, therapeutic approach and pathological tumor stage.
The 5-year overall survival rate of patients with AC (37%; 95% confidence interval 25-49%) was remarkably higher compared to PDAC patients (7%; 95% confidence interval 5-10%). In both cohorts, surgical resection improved survival. Analysis of pathological factors revealed a survival benefit for patients staged with small primary tumors (pT1/2) and exclusion of distant metastases (M0) for both PDAC and AC. Interestingly, absence of lymph node metastasis substantially improved survival in AC, but not in PDAC.
Overall survival of patients with AC is superior compared to that of patients with PDAC. Therapeutically, adequate regional lymph node dissection seems particularly important for the surgical management of AC.
分析壶腹癌（AC）和胰腺导管腺癌（PDAC）患者的生存情况。
1996 年至 2009 年间，分别确诊了 505 例和 69 例 PDAC 和 AC 患者。根据肿瘤实体、治疗方法和病理肿瘤分期分析总生存率。
AC 患者的 5 年总生存率（37%；95%置信区间 25-49%）明显高于 PDAC 患者（7%；95%置信区间 5-10%）。在这两个队列中，手术切除均改善了生存。病理因素分析显示，对于 PDAC 和 AC，原发性肿瘤较小（pT1/2）且无远处转移（M0）的患者有生存获益。有趣的是，AC 中无淋巴结转移显著改善了生存，而 PDAC 中则不然。
与 PDAC 患者相比，AC 患者的总体生存率更高。在治疗上，充分的区域淋巴结清扫对于 AC 的手术治疗似乎尤为重要。
