Number of lymph node metastases: a significant prognostic factor for patients with radical resection of carcinoma of the ampulla of Vater / 中华胃肠外科杂志

ABSTRACT

<p><b>OBJECTIVE</b>To identify prognostic factors predicting survival after radical resection of ampullary carcinoma.</p><p><b>METHODS</b>Clinical data of sixty- five patients with cancer of the ampulla of Vater underwent pancreaticoduodenectomy and regional lymphadenectomy were analyzed retrospectively.</p><p><b>RESULTS</b>A total of 1380 lymph nodes dissected from the resected specimens was examined to detect the presence of metastasis. The median follow- up period was 83 months. Univariate analysis revealed that factors associated with poor survival included the number and the location of positive nodes. Thirty- three of the 65 patients had a total of 116 positive lymph nodes, of whom 20 had 1- 3 positive regional nodes lymph and 13 had > or = 4 positive regional lymph nodes. Multivariate analysis revealed that the number of positive nodes lymph was an independent prognostic factor (P=0.007), while the locations of lymph nodes failed to remain as an independent variable. The survival rate in patients with > or = 4 positive lymph nodes was significantly lower than that in those with 1- 3 positive lymph nodes. The median survival time was 49 months with a 5- year survival rate of 43% in patients with 1- 3 positive lymph nodes, whereas all patients with > or = 4 positive nodes died of the disease within 23 months after resection (P=0.0001).</p><p><b>CONCLUSION</b>The number of positive regional lymph nodes is an independent prognostic factor in patients with ampullary carcinoma after resection.</p>