Predictors of recurrence after pancreaticoduodenectomy for carcinoma of the ampulla of Vater

Objective To investigate the predictors for recurrence of carcinoma ampulla of Vater following pancreatico-duodenectomy.Methods We reviewed the clinical data of 77 patients with carcinoma of the ampulla of Vater who received surgical intervention with pancreaticoduodenectomy.Independent t-test and χ2 test were used for statistical comparison,and logistic regression was used for multivariate analysis to investigate the predictors for tumor recurrence following pancreaticoduodenectomy.Results The tumor recurred in 30 patients following the surgery.Univariate analysis showed that tumor size(P=0.008),tumor invasion depth(P=0.003),lymph node metastasis status(P=0.039),TNM staging(P=0.027),and grade of cell differentiation(P=0.019) were significant prognostic factors of carcinoma of the ampulla of Vater.Multivariate analysis identified tumor size(P=0.032) and grade of cell differentiation(P=0.027) as independent prognostic factors of the carcinoma.Conclusion Distant failure is the predominant recurrence pattern of carcinoma of the ampulla of Vater after curative resections,and tumor size and grade of cell differentiation are the most important factors influencing the outcome of the patients.