Comparison of clinicopathological characteristics between resected ampullary carcinoma and carcinoma of the second portion of the duodenum

作     者：Kohei Nishio Kenjiro Kimura Akihiro Murata Go Ohira Hiroji Shinkawa Shintaro Kodai Ryosuke Amano Shogo Tanaka Sadatoshi Shimizu Shigekazu Takemura Akishige Kanazawa Shoji Kubo Takeaki Ishizawa 

作者机构：Department of Hepato-Biliary-Pancreatic SurgeryOsaka Metropolitan UniversityOsaka 5458585Japan Department of HepatoBiliary-Pancreatic SurgeryOsaka City General HospitalOsaka 5340021Japan 

出 版 物：《World Journal of Gastrointestinal Surgery》 (世界胃肠外科杂志（英文版）（电子版）)

年 卷 期：2022年第14卷第11期

页      面：1219-1229页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

基　　金：Grants-in-Aid for Scientific Research [21K08690] Funding Source: KAKEN 

主　　题：Ampulla of Vater Duodenum Lymphatic metastasis pattern Lymphatic metastasis station Lymph node excision Neoplasm Pancreaticoduodenectomy 

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 *** 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 *** 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.