摘要
BACKGROUND Few studies compared the oncological and biological characteristics between ampullary carcinoma(AC) and cancer of the second portion of the duodenum(DC-Ⅱ), although both tumors arise from anatomically close locations.AIM To elucidate differences in clinicopathological characteristics, especially the patterns of lymph node metastasis(LNM), between AC and DC-Ⅱ.METHODS This was a retrospective cohort study of 80 patients with AC and 27 patients with DC-Ⅱ who underwent pancreaticoduodenectomy between January 1998 and December 2018 in two institutions. Clinicopathological factors, LNM patterns, and prognosis were compared between the two groups.RESULTS The patients with AC and DC-Ⅱ did not exhibit significant differences in 5-year overall survival(66.0% and 67.1%, respectively) and 5-year relapse-free survival(63.5% and 62.2%, respectively). Compared to the patients with DC-Ⅱ, the rate of preoperative biliary drainage was higher(P = 0.042) and the rates of digestive symptoms(P = 0.0158), ulcerative-type cancer(P < 0.0001), large tumor diameter(P < 0.0001), and advanced tumor stage(P = 0.0019) were lower in the patients with AC. The LNM rates were 27.5% and 40.7% in patients with AC and DC-Ⅱ,respectively, without significant difference(P = 0.23). The rates of LNM to hepatic nodes(N-He)and pyloric nodes(N-Py) were significantly higher in patients with DC-Ⅱ than in those with AC(metastasis to N-HE: 18.5% and 5% in patients with DC-Ⅱ and AC, respectively;P = 0.0432;metastasis to N-Py: 11.1% and 0% in patients with DC-Ⅱ and AC, respectively;P = 0.0186)CONCLUSION Although there were no significant differences in the prognosis and recurrence rates between the two groups, metastases to N-He and N-Py were more frequent in patients with DC-Ⅱ than in those with AC.
