[Clinical significance of solitary lymph node metastasis in carcinoma of the ampulla of Vater].

ABSTRACT

OBJECTIVE: To investigate the rule of distribution of solitary lymph node metastasis and its relation with clinico-pathologic factors in carcinoma of ampulla of Vater. METHODS: The data of 26 patients who were discovered to have solitary lymph node metastasis, from 152 patients with carcinoma of the ampulla of Vater who had received pancreatoduodenectomy were retrospectively reviewed. The related clinico-pathologic factors affecting it's metastasis were analyzed and compared with 105 such patients without any lymph node metastasis. RESULTS: Of these 152 patients with carcinoma of ampulla of Vater, 47(30. 9%) had lymph node metastasis and 26 had only solitary lymph node metastasis with a rate of solitary lymph node metastasis of 55. 3% (26/47). The majority of the solitary lymph node metastasis (84. 6% , 22/26) were located at the pancreaticoduodenal region, only 4 patients had skip metastasis. It was revealed by Chi-square test (chi(2) ) that solitary lymph node metastasis was correlated with the tumor size (P = 0. 007) , histological differentiation(P = 0. 003) , T stage(P = 0. 000) and pancreatic infiltration (P =0. 009). CONCLUSION: The majority of solitary lymph node metastasis are located at the pancreaticoduodenal region. Sentinel lymph node assessment may be helpful to determine the extent of lymph node dissection for carcinoma of the ampulla of Vater.