Detailed Abstract
[BP Oral Presentation 4 - Pancreas Disease/Surgery]
[BP OP 4-2] Prognostic impact of precursor lesions of ampullary adenocarcinoma
Sunjong HAN1, Kee-Taek JANG3, Dong Wook CHOI2, Seong Ho CHOI2, Jin Seok HEO2, In Woong HAN2, Yung hun YOU2, DaeJoon PARK2, Youngju RYU2
1Departments of Surgery, Seoul National University Bundang Hospital , Korea
2Departments of Surgery, Samsung Medical Center Sungkyunkwan University College of Medicine, Korea
3Department of Pathology and Translational Genomics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Korea, Korea
Introduction : The aim of this study is to clarify the prognostic impacts of two precursor lesions of ampullary adenocarcinoma, intra-ampullary papillary-tubular neoplasm (IAPN) and flat dysplasia (FD), on survival and to determine the actual survival duration after curative surgery. Furthermore, we intend to identify other risk factors affecting survival.
Methods : From December 1994 to December 2012, a total of 366 patients underwent curative surgery for ampullary adenocarcinoma in Samsung Medical Center.
Results : The 5-year overall and disease-free survival rates of all patients were 59% and 57.9%, respectively. The precursor lesion of 136 (37.2%) patients was IAPN, while that of the ohter 226 (61.7%) was FD. The FD group had more aggressive tumor biology with advanced T stages 3 and 4, nodal involvements, poor differentiation, perineural invasion, lymphovascular invasion and pancreatobiliary or mixed subtype. The 5-year overall survival rate was 70.2% in IAPN group and 51.4% in FD group (p=0.001). The 5-year disease-free survival rate was 70.8% in IAPN group and 49.6% in FD group (p
Conclusions : Patients in the FD group showed significantly worse prognosis with a greater tendency toward advanced disease, and a precursor lesion was an independent prognostic factor for recurrence on multivariate analysis. More studies are needed to clarify the impact of precursor lesions.
Methods : From December 1994 to December 2012, a total of 366 patients underwent curative surgery for ampullary adenocarcinoma in Samsung Medical Center.
Results : The 5-year overall and disease-free survival rates of all patients were 59% and 57.9%, respectively. The precursor lesion of 136 (37.2%) patients was IAPN, while that of the ohter 226 (61.7%) was FD. The FD group had more aggressive tumor biology with advanced T stages 3 and 4, nodal involvements, poor differentiation, perineural invasion, lymphovascular invasion and pancreatobiliary or mixed subtype. The 5-year overall survival rate was 70.2% in IAPN group and 51.4% in FD group (p=0.001). The 5-year disease-free survival rate was 70.8% in IAPN group and 49.6% in FD group (p
Conclusions : Patients in the FD group showed significantly worse prognosis with a greater tendency toward advanced disease, and a precursor lesion was an independent prognostic factor for recurrence on multivariate analysis. More studies are needed to clarify the impact of precursor lesions.
SESSION
BP Oral Presentation 4
Room C 3/31/2018 9:20 AM - 10:10 AM