Survival Analysis according to the Treatment Modalities of the Periampullary Carcinoma

Bae, Joong Sik; Kang, Koo Jeong; Song, Wan Hee; Lim, Tae Jin; Kim, Hong

Abstract

BACKGROUND/AIMS: The periampullary carcinoma includes the tumor originated from pancreatic head, distal bile duct, ampulla of Vater and duodenum. The survival and prognostic factors of these tumors after treatment were investigated according to the treatment modalities.
METHODS
One hundred and sixty patients diagnosed as periampullary carcinoma from March, 1989 through November, 1996, were investigated to determine the clinical and pathological characteristics of periampullary carcinoma on the basis of medical records obtained by a retrograde method. The patients were divided into three groups such as pancreaticoduodenectomy group, bypass surgery group and percutaneous external drainage group. Their survival rates were analyzed according to the three different modalities of treatment and prognostic factors.
RESULTS
The median survival was 24.6 months after pancreaticoduodenectomy, 9.6 months after bypass surgery, and 3.8 months after percutaneous external drainage. In univariate analysis of the survival according to the prognostic factors after radical pancreaticoduodenectomy, origin of the tumor, pathologic differentiation and sex appeared as significant prognostic factors.
CONCLUSIONS
Radical pancreaticoduodenectomy for patients with periampullary carcinoma is crucial for better survival. If the patient is fit to endure the operation and the extent of tumor invasion is limited, pancreaticoduodenectomy is the best choice of treatment.