Background: This was a study of the relation of clinicopathological factors to prognosis in 25 patients who had ampullary carcinoma resected.
Methods: The 5-year survival rate was six of the 25 patients. The presence of microperineural invasion was sought and related to outcome.
Results: Factors relating to prognosis included tumour gross appearance, diameter, pancreatic invasion and microperineural invasion. The 5-year survival rate of 14 patients with microperineural invasion was 3, significantly worse than the 7 in 11 without invasion (P = 0.002, univariate analysis). By multivariate analysis, microperineural invasion was the most important prognostic factor (P = 0.02). Type of tumour recurrence was similar to that in pancreatic carcinoma.
Conclusion: Pancreaticoduodenectomy, rather than local resection, is the procedure of choice in patients with ampullary carcinoma.