Impact of circumferential resection margin on survival in ampullary cancer: retrospective analysis Article Swipe
Anna Nießen
,
Martin Loos
,
Katja Neumüller
,
Manuel Feißt
,
Ulla Klaiber
,
Amila Cizmic
,
Mohammed Al‐Saeedi
,
Susanne Roth
,
Martin Schneider
,
Markus W. Büchler
,
Thilo Hackert
·
YOU?
·
· 2023
· Open Access
·
· DOI: https://doi.org/10.1093/bjsopen/zrad120
YOU?
·
· 2023
· Open Access
·
· DOI: https://doi.org/10.1093/bjsopen/zrad120
Background Ampullary carcinoma is a clinically variable entity. This study aimed to evaluate prognostic factors for the outcome of resected ampullary carcinoma patients with particular intent to analyse the influence of surgical radicality. Methods Patients undergoing resection between 2002 and 2017 were analysed. Clinicopathological parameters, perioperative outcome and survival were examined. Risk factor analysis for postresection survival was performed. Resection margin status was evaluated according to the revised classification for pancreatic adenocarcinoma. Results A total of 234 patients were identified, 97.9 per cent (n = 229) underwent formal resection, while 2.1 per cent (n = 5) underwent ampullary resection. Histological subtypes were 46.6 per cent (n = 109) pancreatobiliary, 34.2 per cent (n = 80) intestinal, 11.5 per cent (n = 27) mixed, and 7.7 per cent (n = 18) undetermined. In the pancreatobiliary group, tumours were more advanced with more vascular resections, pT4 stage, G3 differentiation and pN+ status. Five-year overall survival was significantly different for pancreatobiliary compared to intestinal (51.7 per cent versus 72.8 per cent, P = 0.0087). In univariable analysis, age, pT4 stage, pN+, pancreatobiliary subtype and positive resection margin were significantly associated with worse overall survival. Long-term outcome was significantly better after true R0 resection (circumferential resection margin–, tumour clearance >1 mm) compared with circumferential resection margin+ (<1 mm) and R1 resections (5-year overall survival: 69.6 per cent, median overall survival 191 months versus 42.4 per cent and 53 months; P = 0.0017). Conclusion Postresection survival of ampullary carcinoma patients is determined by histological subtype and surgical radicality. Intestinal differentiation is associated with less advanced tumour stages and better differentiation, which is reflected in a significantly better overall survival compared to pancreatobiliary differentiation. Despite this, true R0-resection is a prognostic key determinant in both entities, achieving 5-year survival in two-thirds of patients.
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Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1093/bjsopen/zrad120
- https://academic.oup.com/bjsopen/article-pdf/7/6/zrad120/54917745/zrad120.pdf
- OA Status
- gold
- Cited By
- 2
- References
- 29
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4390364756
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
-
https://openalex.org/W4390364756Canonical identifier for this work in OpenAlex
- DOI
-
https://doi.org/10.1093/bjsopen/zrad120Digital Object Identifier
- Title
-
Impact of circumferential resection margin on survival in ampullary cancer: retrospective analysisWork title
- Type
-
articleOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2023Year of publication
- Publication date
-
2023-11-01Full publication date if available
- Authors
-
Anna Nießen, Martin Loos, Katja Neumüller, Manuel Feißt, Ulla Klaiber, Amila Cizmic, Mohammed Al‐Saeedi, Susanne Roth, Martin Schneider, Markus W. Büchler, Thilo HackertList of authors in order
- Landing page
-
https://doi.org/10.1093/bjsopen/zrad120Publisher landing page
- PDF URL
-
https://academic.oup.com/bjsopen/article-pdf/7/6/zrad120/54917745/zrad120.pdfDirect link to full text PDF
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YesWhether a free full text is available
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-
goldOpen access status per OpenAlex
- OA URL
-
https://academic.oup.com/bjsopen/article-pdf/7/6/zrad120/54917745/zrad120.pdfDirect OA link when available
- Concepts
-
Medicine, Resection margin, Perioperative, Adenocarcinoma, Surgery, Stage (stratigraphy), Carcinoma, Survival analysis, Retrospective cohort study, Resection, Overall survival, Pancreatic cancer, Gastroenterology, Cancer, Internal medicine, Paleontology, BiologyTop concepts (fields/topics) attached by OpenAlex
- Cited by
-
2Total citation count in OpenAlex
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2024: 2Per-year citation counts (last 5 years)
- References (count)
-
29Number of works referenced by this work
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-
10Other works algorithmically related by OpenAlex
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