Ampullary Cancer: Prognostic Factors and Survival

Authors

  • André Cortesão Faculdade de Medicina, Universidade de Coimbra, Coimbra, Portugal; Serviço de Cirurgia Geral, Unidade Local de Saúde de Coimbra Coimbra, Portugal https://orcid.org/0000-0003-3182-8823
  • João Simões Faculdade de Medicina, Universidade de Coimbra, Coimbra, Portugal; Serviço de Cirurgia Geral, Unidade Local de Saúde de Coimbra Coimbra, Portugal https://orcid.org/0000-0002-6467-2637
  • José Guilherme Tralhão Faculdade de Medicina, Universidade de Coimbra, Coimbra, Portugal; Serviço de Cirurgia Geral, Unidade Local de Saúde de Coimbra Coimbra, Portugal; Coimbra Institute for Clinical and Biomedical Research (iCBR), Coimbra, Portugal https://orcid.org/0000-0002-5641-6975

DOI:

https://doi.org/10.34635/rpc.1119

Keywords:

Ampulla of Vater, Common Bile Duct Neoplasms, Pancreaticoduodenectomy

Abstract

Introduction: Ampullary cancer is a periamullary neoplasia with a low incidence but a high mortality rate. This study aimed to assess the impact of ampullary characteristics on overall survival and disease-free survival.


Methods: Retrospective study of 40 patients diagnosed with ampullary cancer who underwent radical cephalic duodenopancreatectomy between 2009 and 2019. We analyzed survival using Kaplan-Meier curves and non-parametric tests, with significance set at p<0.05.


Results: The median overall survival was 41 months (0-154), with a survival rate of 75%, 44%, and 31.6% at 1, 5, and 10 years post-surgery, respectively. The median disease-free survival was 15 months (0-154). Factors impacting overall survival included perineural invasion (p=0.016), pathological N stage (p<0.01), and the number of invaded lymph nodes (p=0.043). Factors influencing disease-free survival were age at surgery (p=0.009), preoperative total bilirubin level (p=0.018), and hematocrit level (p=0.039).


Conclusion: This study represents a series of ampulloma cases studied in Portugal, reflecting overall and disease-free survival, and confirming the aggressiveness of this rare tumor.

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Published

2026-03-13

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