Ann Hepatobiliary Pancreat Surg.  2022 May;26(2):138-143. 10.14701/ahbps.21-129.

Factors influencing patterns of recurrence following pancreaticoduodenectomy for patients with distal bile duct cancer and ampulla of Vater cancer

• Lee DH
• Kim HJ
• Cho CW
• Yun SS
• Lee DS

• KMID: 2530092
• DOI: http://doi.org/10.14701/ahbps.21-129

Abstract

Backgrounds/Aims
Pancreaticoduodenectomy (PD) is a standard surgical procedure for patients with periampullary cancer. During the follow-up period after PD, recurrence can be observed in various places with different prognosis. The aim of this study was to clarify the pattern of recurrence and factors affecting the survival of patients with periampullary cancer.
Methods
Overall, 88 patients who received PD for distal common bile duct cancer or ampulla of Vater cancer were finally included and their clinical characteristics were analyzed. Patients were divided into three groups: recurrence-free (RF) group, an isolated locoregional recurrence (LR) group, and a distant metastasis (DM) group. Prognostic factors affecting recurrence in each group were analyzed and a survival analysis was performed.
Results
Perineural invasion (PNI), T stage, and lymphovascular invasion (LVI) were significant risk factors for LR and PNI, lymph node metastasis, LVI, and T stage were associated with DM group compared to RF group in univariate analysis, respectively. N stage and PNI were significant risk factors (p = 0.046, p = 0.041) in overall survival of the LR and the DM groups. There was no significant difference in 5-year overall survival between the LR and DM groups.
Conclusions
T stage was a significant risk factor of LR, while PNI was a significant risk factor of DM. There was no significant difference in overall survival depending on the site of recurrence.

Keyword

Pancreaticoduodenectomy; Bile duct cancer; Recurrence; Metastasis

Figure

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  Fig. 1 Overall survival according to recurrence pattern.

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  Fig. 2 Overall survival according to cancer type. dCBD, distal common bile duct; AoV, ampulla of Vater.

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