Prognostic significance of necrosis in ampullary carcinomas.

ABSTRACT

BACKGROUND/AIMS: Necrosis is an important pathological feature that reflects high malignancy potential in tumors such as hepatocellular carcinoma and renal cell carcinoma. We aimed to elucidate the prognostic impact of necrosis in ampullary carcinomas. MATERIALS AND METHODS: We reviewed 101 consecutive cases of ampullary carcinoma for tumor necrosis, types of necrosis, macroscopic and microscopic histopathological subtypes, lymphatic-vascular-perineural invasions, and other histopathological parameters. RESULTS: Tumor necrosis was present in 19 (18.8%) cases and was identified as an independent poor prognostic indicator in multivariate survival analysis (p = 0.029). CONCLUSION: The presence of necrosis in ampullary carcinomas is directly related to vascular and perineural invasion and is a poor prognostic indicator independent of tumor stage. Including the presence of necrosis in the pathology reports of ampullary carcinomas will facilitate risk stratification.