We have located links that may give you full text access.
Ampullary cancer and preoperative jaundice: possible indication of the minimal surgery.
Hepato-gastroenterology 2009 July
BACKGROUND/AIMS: Obstructive jaundice is common symptom of carcinoma of the ampulla of Vater. In the present study we evaluated association between preoperative jaundice and prognosis and possible indication of the minimal surgery.
METHODOLOGY: Clinicopathological features of 50 patients who underwent curative resection were examined retrospectively and statistically analyzed.
RESULTS: Thirty-two of the 50 patients (64%) had preoperative jaundice, and these patients had poorer survival compared with these without jaundice (5 year survival 57.2% vs. 100%, p < 0.01). Preoperative jaundice, serum carbohydrate antigen 19-9 level, pancreatic invasion, lymphatic invasion, venous invasion, perineural invasion, duodenal invasion, margin status, lymph node metastasis, and T stage were shown to be significant prognostic factors. In the 18 patients without preoperative jaundice, lymphatic invasion was significantly related to lymph node metastasis. In addition, 12 of the 14 patients without jaundice and lymphatic invasion were diagnosed as T1N0 (stage IA) disease, and all the tumors were papillary or well-differentiated adenocarcinoma.
CONCLUSIONS: Preoperative jaundice may reflect advanced-stage in case of ampullary cancer. Radical surgery may not be necessary in patients without preoperative jaundice if the tumor is diagnosed as a papillary or well-differentiated adenocarcinoma without lymphatic invasion.
METHODOLOGY: Clinicopathological features of 50 patients who underwent curative resection were examined retrospectively and statistically analyzed.
RESULTS: Thirty-two of the 50 patients (64%) had preoperative jaundice, and these patients had poorer survival compared with these without jaundice (5 year survival 57.2% vs. 100%, p < 0.01). Preoperative jaundice, serum carbohydrate antigen 19-9 level, pancreatic invasion, lymphatic invasion, venous invasion, perineural invasion, duodenal invasion, margin status, lymph node metastasis, and T stage were shown to be significant prognostic factors. In the 18 patients without preoperative jaundice, lymphatic invasion was significantly related to lymph node metastasis. In addition, 12 of the 14 patients without jaundice and lymphatic invasion were diagnosed as T1N0 (stage IA) disease, and all the tumors were papillary or well-differentiated adenocarcinoma.
CONCLUSIONS: Preoperative jaundice may reflect advanced-stage in case of ampullary cancer. Radical surgery may not be necessary in patients without preoperative jaundice if the tumor is diagnosed as a papillary or well-differentiated adenocarcinoma without lymphatic invasion.
Full text links
Related Resources
Trending Papers
A Guide to the Use of Vasopressors and Inotropes for Patients in Shock.Journal of Intensive Care Medicine 2024 April 14
British Society for Rheumatology guideline on management of adult and juvenile onset Sjögren disease.Rheumatology 2024 April 17
Albumin: a comprehensive review and practical guideline for clinical use.European Journal of Clinical Pharmacology 2024 April 13
Renin-Angiotensin-Aldosterone System: From History to Practice of a Secular Topic.International Journal of Molecular Sciences 2024 April 5
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app