Clinicopathologic Features of Early Recurrence Cases after Pancreatoduodenectomy in Periampullary Carcinoma

Lee, Young Cheol; Kim, Jung Jin; Kang, Hyung Kil; Lee, Samuel; Kim, Joo Seop; Kim, Hong Ki; Lee, Bong Wha

Abstract

BACKGROUND/AIMS: Periampullary carcinoma could recur early even after curative resection in the small-sized lesion. The aim of this study is to clarify the clinicopathologic features of early recurrence cases after pancreatoduodenectomy in periampullary carcinoma.
METHODS
15 cases (group I) of recurrence within 6 months after pancreatoduodenectomy were compared clinicopathologically with 17 cases (group II) of no recurrence until 2 years after pancreatoduodenectomy between 1991 and 2000 in Hallym medical center.
RESULTS
There were no differences in sex and age distri- butions between two groups (M/F ratio=8/7 vs 8/9, and average age=56.9 vs 57.5). The distributions of primary lesions were 4 cases of ampulla of Vater, 6 cases of common bile duct, 5 cases of pancreatic head in group I; 7 cases of ampulla of Vater, 8 cases of common bile duct, 2 cases of pancreatic head in group II, respectively. There were no differences in tumor size (2.8+/-1.1 cm vs. 2.4+/-1.5 cm), the number of lymph node metastasis, AJCC tumor stage, histological differentiation, neural or lymphatic invasion between two groups. The number of direct invasion to adjacent organs in group I was more than that in group II (p<0.05).
CONCLUSION
The increased number of direct invasion to adjacent organs could be an important prognostic factor of early recurrence after pancreatoduodenectomy even in small-sized or no lymph node-metastasized periampullary carcinoma.