Long-Term Outcome of Surgical Treatment for Ampullary Carcinoma

Background/Aims: We aimed to clarify the surgical indication and describe the long-term surgical outcome for ampullary carcinoma. Methodology: The long-term outcomes of 23 patients who underwent pancreaticoduodenectomy were retrospectively reviewed. The prognostic factors for cancer-specific survival and overall survival after surgery were investigated. Results: The cancer-specific 5-, 10- and 20-year survival rates after resection of the ampullary carcinoma were 52%, 43% and 43%, respectively, while the corresponding overall survival rates were 52%, 32% and 24%, respectively. Ten of the 11 patients with recurrent ampullary carcinoma died within 5 years after surgery. Four patients died because of pancreatic cancer, colon cancer, old age after curative resection of gastric cancer, and pneumonia at later than 5 years after the surgery. The risk factors for the short cancer-specific survival period were pancreatic invasion and lymph node metastasis, while those for the short overall survival period were pancreatic invasion and the tumor grade. Conclusions: Our study indicates that recurrence of ampullary carcinoma within 5 years after its resection, especially in patients with pancreatic invasion or lymph node metastasis and development of other diseases after more than 5 years after the surgery should be carefully investigated.