Analysis of Outcomes after Curative Resection of Ampullary Carcinoid Tumor

Kwon, Sea Hyun; Hwang, Shin; Lee, Sung Gyu; Lee, Young Joo; Han, Duck Jong; Park, Kwang Min; Kim, Song Cheol; Ryu, Je Ho; Park, Jeong Ik; Lee, Hyo Jun

Abstract

PURPOSE: Ampullary carcinoid tumors are rare and therefore the clinicopathologic characteristics and prognosis after radical surgery have yet to be clarified. The goal of this study was to analyze the outcome of ampullary carcinoid tumors in patients who underwent radical curative resection.
METHODS
From January 1998 to December 2005, 10 patients (3.4%) were diagnosed with an ampullary carcinoid tumor among 294 patients who underwent pancreatoduodenectomy for various ampullary neoplasms. The clinical findings from these 10 patients were retrospectively analyzed.
RESULTS
The mean patient age was 58.0 +/- 13.4 years and seven were male. A standard pancreatoduodenectomy was performed in three patients and pylorus-preserving pancreatoduodenectomy in seven. An R0 resection was achieved in all 10 patients. The mean tumor size was 2.1 +/- 1.3 cm. Synaptophysin staining was positive in 10 and chromogranin staining was positive in eight patients. The overall and disease-free survival rates were 90% and 80% at 1 year and 64% and 56% at 3 years, respectively. Univariate analyses revealed that a maximum tumor diameter > or = 2 cm and tumor invasion beyond the ampulla were significant risk factors for tumor recurrence.
CONCLUSIONS
The results of this study showed that performing a radical resection is the treatment of choice, with the intention of total tumor removal and the possibility of cure.