Ampullary adenocarcinoma, arising at the ampulla of Vater in the duodenum, is a gastrointestinal malignancy often treated with surgical resection with curative intent. However, the histopathologic characteristics of the resected tumor that may help predict the course of the disease are unknown. This retrospective cohort study enrolled patients who underwent pancreatoduodenectomy with curative intent for ampullary adenocarcinoma (n=887) to define histopathologic characteristics that independently predict overall survival and disease-free survival in this patient population. The median overall survival was 64 months. Researchers found that independent predictors of overall survival included adjuvant chemotherapy, which improved overall survival (HR 0.69, 95% CI 0.48 to 0.97), N-stage (HR 3.30, 95% CI 2.09 to 5.21) and perineural invasion (HR 1.50, 95% CI 1.01 to 2.23) were also both independently associated with lower overall survival. N-stage was also an independent adverse predictor for disease-free survival (HR 2.65, 95% CI 1.65 to 4.27), while other variables were not independently associated. Investigators concluded that these histopathologic characteristics could better help predict survival after the resection of ampullary adenocarcinoma with curative intent.
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