摘要
BACKGROUND Ampullary adenocarcinoma(AAC)is a rare neoplasm that accounts for only 0.2%of all gastrointestinal cancers.Its incidence rate is lower than 6 cases per million people.Different prognostic factors have been described for AAC and are associated with a wide range of survival rates.However,these studies have been exclusively conducted in patients originating from Asian,European,and North American countries.AIM To evaluate the histopathologic predictors of overall survival(OS)in South American patients with AAC treated with curative pancreaticoduodenectomy(PD).METHODS We analyzed retrospective data from 83 AAC patients who underwent curative(R0)PD at the National Cancer Institute of Peru between January 2010 and October 2020 to identify histopathologic predictors of OS.RESULTS Sixty-nine percent of patients had developed intestinal-type AAC(69%),23%had pancreatobiliary-type AAC,and 8%had other subtypes.Forty-one percent of patients were classified as Stage I,according to the AJCC 8 th Edition.Recurrence occurred primarily in the liver(n=8),peritoneum(n=4),and lung(n=4).Statistical analyses indicated that T3 tumour stage[hazard ratio(HR)of 6.4,95%confidence interval(CI)of 2.5-16.3,P<0.001],lymph node metastasis(HR:4.5,95%CI:1.8-11.3,P=0.001),and pancreatobiliary type(HR:2.7,95%CI:1.2-6.2,P=0.025)were independent predictors of OS.CONCLUSION Extended tumour stage(T3),pancreatobiliary type,and positive lymph node metastasis represent independent predictors of a lower OS rate in South American AAC patients who underwent curative PD.
