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1. Tang W, Inagaki Y, Kokudo N, Guo Q, Seyama Y, Nakata M, Imamura H, Sano K, Sugawara Y, Makuuchi M: KL-6 mucin expression in carcinoma of the ampulla of Vater: association with cancer progression. World J Gastroenterol; 2005 Sep 21;11(35):5450-4
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  • [Title] KL-6 mucin expression in carcinoma of the ampulla of Vater: association with cancer progression.
  • AIM: To assess histochemical expression of KL-6 and its clinicopathological significance in carcinoma of the ampulla of Vater.
  • METHODS: Ampullary carcinoma tissues were collected from 38 patients who underwent pancreatoduodenectomy or local resection.
  • RESULTS: Positive staining of ampullary carcinoma cells was observed in 26 (68.4%) cases.
  • Staining was not found in the surrounding non-cancer regions of the ampullary tissues.
  • Remarkable KL-6 expression was observed in invasive carcinoma cells in pancreatic and duodenal tissues and in metastatic carcinoma cells in lymph nodes.
  • Positive KL-6 expression was related to lymph node metastasis (P = 0.020), pancreatic invasion (P = 0.016), duodenal invasion (P = 0.034), and advanced stage of TNM clinical classification (P = 0.010).
  • CONCLUSION: The aberrant expression of KL-6 mucin is significantly related to unfavorable behaviors of carcinoma of the ampulla of Vater.
  • [MeSH-major] Ampulla of Vater. Antigens / metabolism. Common Bile Duct Neoplasms / metabolism. Glycoproteins / metabolism. Mucins / metabolism

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  • (PMID = 16222735.001).
  • [ISSN] 1007-9327
  • [Journal-full-title] World journal of gastroenterology
  • [ISO-abbreviation] World J. Gastroenterol.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] China
  • [Chemical-registry-number] 0 / Antigens; 0 / Antigens, Neoplasm; 0 / Glycoproteins; 0 / MUC1 protein, human; 0 / Mucin-1; 0 / Mucins
  • [Other-IDs] NLM/ PMC4320352
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2. Prenzel KL, Warnecke-Eberz U, Brabender J, Baldus SE, Bollschweiler E, Gutschow CA, Drebber U, Hoelscher AH, Schneider PM: Differential c-erbB-1 and c-erbB-2 mRNA expression in cancer of the pancreas compared with cancer of the papilla of Vater. World J Gastroenterol; 2006 Jan 21;12(3):437-42
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  • [Title] Differential c-erbB-1 and c-erbB-2 mRNA expression in cancer of the pancreas compared with cancer of the papilla of Vater.
  • AIM: We examined quantitative mRNA expression of growth factor receptors (c-erbB-1, c-erbB-2) and the anti-apoptosis gene survivin known to be regulated in pancreatic adenocarcinomas and compared the expression pattern with that in carcinomas of the papilla of Vater.
  • METHODS: Quantitative real-time reverse transcriptase-PCR (QRT-PCR, Taqman) was performed to analyze mRNA expression levels of c-erbB-1, c-erbB-2 and survivin in normal and corresponding tumor samples of 31 pancreatic adenocarcinomas and 8 cancers of the papilla of Vater.
  • RESULTS: The overall median mRNA expression of survivin was significantly increased in both adenocarcinoma of the pancreas (P<0.01) and papilla of Vater (P<0.008) compared with uninvolved normal control tissue.
  • In pancreatic cancer, expression of c-erbB-1 was significantly decreased compared with the normal pancreatic tissue (P<0.03), whereas in the cancer of the papilla of Vater expression of c-erbB-2 was significantly downregulated (P<0.05) compared with the paired normal samples.
  • Gene expression was not associated with tumor stage, differentiation or prognosis.
  • CONCLUSION: The common anti-apoptosis gene survivin is overexpressed both in the cancer of the papilla of Vater and pancreas.
  • In contrast, the growth factor receptor genes c-erbB-1 and c-erbB-2 are differentially regulated in both tumor entities adding further evidence that pancreatic cancer is biologically different from the cancer of papilla of Vater.
  • [MeSH-major] Adenocarcinoma / metabolism. Ampulla of Vater. Common Bile Duct Neoplasms / metabolism. Pancreatic Neoplasms / metabolism. RNA, Messenger / genetics. Receptor, Epidermal Growth Factor / metabolism. Receptor, ErbB-2 / metabolism

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  • (PMID = 16489645.001).
  • [ISSN] 1007-9327
  • [Journal-full-title] World journal of gastroenterology
  • [ISO-abbreviation] World J. Gastroenterol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] China
  • [Chemical-registry-number] 0 / BIRC5 protein, human; 0 / Inhibitor of Apoptosis Proteins; 0 / Microtubule-Associated Proteins; 0 / Neoplasm Proteins; 0 / RNA, Messenger; EC 2.7.10.1 / Receptor, Epidermal Growth Factor; EC 2.7.10.1 / Receptor, ErbB-2
  • [Other-IDs] NLM/ PMC4066064
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3. Zhou J, Hsu CC, Winter JM, Pawlik TM, Laheru D, Hughes MA, Donehower R, Wolfgang C, Akbar U, Schulick R, Cameron J, Herman JM: Adjuvant chemoradiation versus surgery alone for adenocarcinoma of the ampulla of Vater. Radiother Oncol; 2009 Aug;92(2):244-8
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  • [Title] Adjuvant chemoradiation versus surgery alone for adenocarcinoma of the ampulla of Vater.
  • BACKGROUND AND PURPOSE: To examine the role of adjuvant chemoradiation (CRT) in patients with resected ampullary adenocarcinoma.
  • MATERIALS AND METHODS: The records of patients who underwent curative surgery for ampullary adenocarcinoma at a single institution between 1992 and 2007 were reviewed.
  • Adverse prognostic factors for OS included T stage (T3/4 vs. T1/T2, p=0.046), node status (positive vs. negative, p<0.001), and histological grade (grade 3 vs. 1/2, p=0.09).
  • Patients receiving CRT were more likely to have advanced T-stage (p=0.001), node positivity (p<0.001), and poor histologic grade (p=0.015).
  • CONCLUSIONS: Adjuvant chemoradiation following curative resection for ampullary adenocarcinoma did not lead to a statistically significant benefit in overall survival.
  • [MeSH-major] Adenocarcinoma / therapy. Ampulla of Vater. Common Bile Duct Neoplasms / therapy

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  • (PMID = 19541379.001).
  • [ISSN] 1879-0887
  • [Journal-full-title] Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology
  • [ISO-abbreviation] Radiother Oncol
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / P30 CA006973
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] Ireland
  • [Other-IDs] NLM/ NIHMS443631; NLM/ PMC3700350
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4. Iacono C, Verlato G, Zamboni G, Scarpa A, Montresor E, Capelli P, Bortolasi L, Serio G: Adenocarcinoma of the ampulla of Vater: T-stage, chromosome 17p allelic loss, and extended pancreaticoduodenectomy are relevant prognostic factors. J Gastrointest Surg; 2007 May;11(5):578-88

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Adenocarcinoma of the ampulla of Vater: T-stage, chromosome 17p allelic loss, and extended pancreaticoduodenectomy are relevant prognostic factors.
  • OBJECTIVE: To evaluate the prognostic significance of different clinico-pathological and molecular factors, and to compare survival after standard and extended pancreaticoduodenectomy (PD) in ampulla of Vater adenocarcinoma (AVAC).
  • Sixteen patients had T-stages 1-2, 14 T-stage 3, and 29 T-stage 4 cancers.
  • At univariate analysis, poor survival was associated with cancer ulceration (P = 0.051), poor differentiation (P = 0.008), T-stage 4 (P < 0.001), nodal metastases (P = 0.004), chromosome 17p (P < 0.001) and 18q LOH (P = 0.002), and absence of MSI (P = 0.009).
  • At multivariate analysis, only T-stage (P = 0.002) and 17p LOH (P = 0.001) were independent predictors of survival.
  • All patients with MSI-positive cancers were long-survivors (>12 yrs), whereas only 30% of MSI-negative cancer patients survived at 5 years.
  • CONCLUSION: MSI and chromosome 17p status allow to better define prognosis within ampullary cancers at the same stage.
  • Surgery alone resulted curative in MSI-positive cancer patients, whereas it was inadequate in patients showing allelic losses, who might benefit from adjuvant therapy.
  • [MeSH-major] Adenocarcinoma / pathology. Ampulla of Vater / pathology. Chromosomes, Human, Pair 17 / genetics. Common Bile Duct Neoplasms / pathology. Loss of Heterozygosity / genetics. Pancreaticoduodenectomy

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  • (PMID = 17468917.001).
  • [ISSN] 1091-255X
  • [Journal-full-title] Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract
  • [ISO-abbreviation] J. Gastrointest. Surg.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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5. Hsu HP, Shan YS, Hsieh YH, Yang TM, Lin PW: Predictors of recurrence after pancreaticoduodenectomy in ampullary cancer: comparison between non-, early and late recurrence. J Formos Med Assoc; 2007 Jun;106(6):432-43
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  • [Title] Predictors of recurrence after pancreaticoduodenectomy in ampullary cancer: comparison between non-, early and late recurrence.
  • BACKGROUND/PURPOSE: Ampullary cancer is one of the periampullary cancers with a better prognosis, but relapse still occurs early in some patients.
  • METHODS: Between January 1989 and March 2006, information was gathered on a total of 127 patients undergoing pancreaticoduodenectomy with regional lymphadenectomy for ampullary cancer at National Cheng Kung University Hospital and Tainan Municipal Hospital.
  • The early and late recurrence patients had higher levels of microscopically (R1) or macroscopically (R2) positive margin of resection and more advanced disease (advanced tumor stage, numbers of lymph nodes involved, lymph node status, pancreatic invasion and TNM stage) than the non-recurrence group.

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  • (PMID = 17588836.001).
  • [ISSN] 0929-6646
  • [Journal-full-title] Journal of the Formosan Medical Association = Taiwan yi zhi
  • [ISO-abbreviation] J. Formos. Med. Assoc.
  • [Language] ENG
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] Singapore
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6. Hatzaras I, George N, Muscarella P, Melvin WS, Ellison EC, Bloomston M: Predictors of survival in periampullary cancers following pancreaticoduodenectomy. Ann Surg Oncol; 2010 Apr;17(4):991-7
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  • BACKGROUND: Cancers of the ampulla of Vater, distal common bile duct, and pancreas are known to have dismal prognosis.
  • It is often reported that ampullary cancers are less aggressive relative to the other periampullary carcinomas.
  • METHODS: We reviewed the records of all patients who underwent pancreaticoduodenectomy for periampullary carcinoma between 1992 and 2007 at the Ohio State University Medical Center.
  • RESULTS: 346 consecutive periampullary malignancies (249 pancreatic cancers, 79 ampullary carcinomas, 18 extrahepatic cholangiocarcinomas) treated by pancreaticoduodenectomy were identified.
  • Pancreatic cancer histology correlated with the shortest median survival (17.1 months), followed by cholangiocarcinoma (17.9 months) and ampullary carcinoma (44.3 months) (P < 0.001).
  • CONCLUSIONS: Although ampullary cancers have the best prognosis overall, when controlled for tumor stage, only presence of neural invasion and nodal metastasis predict poor survival following pancreaticoduodenectomy.

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  • (PMID = 20108122.001).
  • [ISSN] 1534-4681
  • [Journal-full-title] Annals of surgical oncology
  • [ISO-abbreviation] Ann. Surg. Oncol.
  • [Language] ENG
  • [Grant] United States / NCI NIH HHS / CA / CA133250-01; United States / NCI NIH HHS / CA / K12 CA133250; United States / NCI NIH HHS / CA / 1 K12 CA133250; United States / NCI NIH HHS / CA / K12 CA133250-01
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural
  • [Publication-country] United States
  • [Other-IDs] NLM/ NIHMS190333; NLM/ PMC2861840
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7. Umetani N, Kim J, Hiramatsu S, Reber HA, Hines OJ, Bilchik AJ, Hoon DS: Increased integrity of free circulating DNA in sera of patients with colorectal or periampullary cancer: direct quantitative PCR for ALU repeats. Clin Chem; 2006 Jun;52(6):1062-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Increased integrity of free circulating DNA in sera of patients with colorectal or periampullary cancer: direct quantitative PCR for ALU repeats.
  • Unlike uniformly truncated DNA released from apoptotic nondiseased cells, DNA released from dead cancer cells varies in size.
  • We developed a novel method to measure the ratio of longer to shorter DNA fragments (DNA integrity) in serum as a potential biomarker for patients with colorectal cancer (CRC) or periampullary cancers (PACs).
  • METHODS: Sera from 32 patients with CRC (3 stage I, 14 stage II, 6 stage III, and 9 stage IV patients), 19 patients with PACs (2 stage I, 9 stage II, 1 stage III, and 7 stage IV patients), and 51 healthy volunteers were assessed by quantitative real-time PCR of ALU repeats (ALU-qPCR) with 2 sets of primers (115 and 247 bp) amplifying different lengths of DNA.
  • RESULTS: ALU-qPCR had a detection limit of 0.01 pg of DNA.
  • Serum DNA integrity was significantly increased for stage I/II and III/IV CRC and stage I/II and III/IV PACs (P = 0.002, P = 0.006, P = 0.022, and P <0.0001, respectively).
  • ROC curves for detecting CRC and PACs had areas under the curves of 0.78 and 0.80, respectively.
  • [MeSH-major] Ampulla of Vater. Biomarkers, Tumor / blood. Carcinoma, Pancreatic Ductal / diagnosis. Colorectal Neoplasms / diagnosis. Common Bile Duct Neoplasms / diagnosis. DNA / blood. Duodenal Neoplasms / diagnosis. Pancreatic Neoplasms / diagnosis


8. Kim K, Chie EK, Jang JY, Kim SW, Oh DY, Im SA, Kim TY, Bang YJ, Ha SW: Role of adjuvant chemoradiotherapy for ampulla of Vater cancer. Int J Radiat Oncol Biol Phys; 2009 Oct 1;75(2):436-41
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Role of adjuvant chemoradiotherapy for ampulla of Vater cancer.
  • PURPOSE: To evaluate the role of adjuvant chemoradiotherapy for ampulla of Vater cancer.
  • METHODS AND MATERIALS: Between January 1991 and December 2002, 118 patients with ampulla of Vater cancer underwent en bloc resection.
  • When age, type of operation, T stage, N stage, histologic differentiation, and the use of adjuvant chemoradiotherapy were incorporated into the Cox proportional hazard model, there was an improvement in the locoregional relapse-free survival rate (p = 0.0050) and a trend toward a longer overall survival (p = 0.0762) associated with the use of adjuvant chemoradiotherapy.
  • CONCLUSIONS: Adjuvant chemoradiotherapy may enhance locoregional control and overall survival in patients with ampulla of Vater cancer after curative resection, especially in those with nodal involvement.
  • [MeSH-major] Ampulla of Vater. Common Bile Duct Neoplasms / drug therapy. Common Bile Duct Neoplasms / radiotherapy

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  • (PMID = 19394162.001).
  • [ISSN] 1879-355X
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Evaluation Studies; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antimetabolites, Antineoplastic; U3P01618RT / Fluorouracil
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9. Shan Y, Zhao DB, Che X, Wang JX, Shao YF, Zhao P: [Clinical significance of solitary lymph node metastasis in carcinoma of the ampulla of Vater]. Zhonghua Zhong Liu Za Zhi; 2006 Sep;28(9):694-6

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Clinical significance of solitary lymph node metastasis in carcinoma of the ampulla of Vater].
  • 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.
  • RESULTS: Of these 152 patients with carcinoma of ampulla of Vater, 47(30.
  • 003) , T stage(P = 0.
  • Sentinel lymph node assessment may be helpful to determine the extent of lymph node dissection for carcinoma of the ampulla of Vater.
  • [MeSH-major] Adenocarcinoma / pathology. Ampulla of Vater. Common Bile Duct Neoplasms / pathology

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  • (PMID = 17274378.001).
  • [ISSN] 0253-3766
  • [Journal-full-title] Zhonghua zhong liu za zhi [Chinese journal of oncology]
  • [ISO-abbreviation] Zhonghua Zhong Liu Za Zhi
  • [Language] chi
  • [Publication-type] English Abstract; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] China
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10. Qiao QL, Zhao YG, Ye ML, Yang YM, Zhao JX, Huang YT, Wan YL: Carcinoma of the ampulla of Vater: factors influencing long-term survival of 127 patients with resection. World J Surg; 2007 Jan;31(1):137-43; discussion 144-6

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Carcinoma of the ampulla of Vater: factors influencing long-term survival of 127 patients with resection.
  • INTRODUCTION: The prognosis for patients with carcinoma of the ampulla of Vater is improved relative to other periampullary neoplasms.
  • Identification of independent prognostic factors in ampullary carcinomas has been limited by the small number of tumors resected.
  • The aim of the present study was to determine the clinicopathologic factors that influence long-term survival in patients with resected ampullary carcinoma.
  • METHODS: Clinicopathologic data were retrospectively reviewed for patients with ampullary carcinomas radically resected between March 1987 and September 2002.
  • Ampullary carcinomas were radically resected in 127 patients either by pancreaticoduodenectomy (n = 124) or local resection (n = 3).
  • Factors that significantly influenced survival were lymph node status (P < 0.001), depth of tumor infiltration (P = 0.029), and TNM stage (P < 0.001) on univariate analysis.
  • CONCLUSIONS: Carcinoma of the ampulla of Vater has a higher resectability rate and a much better survival rate than pancreatic cancer.
  • [MeSH-major] Adenocarcinoma / mortality. Adenocarcinoma / surgery. Ampulla of Vater. Common Bile Duct Neoplasms / mortality. Common Bile Duct Neoplasms / surgery. Pancreaticoduodenectomy

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  • (PMID = 17171495.001).
  • [ISSN] 0364-2313
  • [Journal-full-title] World journal of surgery
  • [ISO-abbreviation] World J Surg
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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11. Liu N, Liang H, Li Q, Wang DC, Zhang RP, Wang JC, Hao XS: [Determinants of long-term survival in 38 patients with carcinoma of ampulla of Vater treated by local resection]. Zhonghua Zhong Liu Za Zhi; 2005 Oct;27(10):629-31

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Determinants of long-term survival in 38 patients with carcinoma of ampulla of Vater treated by local resection].
  • OBJECTIVE: To investigate determinants of long-term survival for carcinoma of ampulla of Vater treated by local resection.
  • RESULTS: Thirty-eight patients received local resection giving an operative mortality of 0% and morbidity of 13.2%.
  • The tumour size, tumour grading, lymph node status and UICC stage were significant prognostic factors in univariate analysis.
  • Preferably it is indicated only in high risk patients with a pT1 and well differentiated ampullary cancer smaller than 1 cm in diameter.
  • [MeSH-major] Adenocarcinoma / surgery. Ampulla of Vater / surgery. Common Bile Duct Neoplasms / surgery

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  • (PMID = 16438877.001).
  • [ISSN] 0253-3766
  • [Journal-full-title] Zhonghua zhong liu za zhi [Chinese journal of oncology]
  • [ISO-abbreviation] Zhonghua Zhong Liu Za Zhi
  • [Language] chi
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] China
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12. Woo SM, Ryu JK, Lee SH, Lee WJ, Hwang JH, Yoo JW, Park JK, Kang GH, Kim YT, Yoon YB: Feasibility of endoscopic papillectomy in early stage ampulla of Vater cancer. J Gastroenterol Hepatol; 2009 Jan;24(1):120-4

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Feasibility of endoscopic papillectomy in early stage ampulla of Vater cancer.
  • BACKGROUND AND AIM: Although endoscopic papillectomy has been attempted in early stage ampullary cancer (pTis, T1), its curative role and indications remain uncertain.
  • METHODS: We performed a retrospective analysis of clinical and histopathological data of 216 patients with ampullary cancer between 1991 and 2006.
  • RESULTS: No tumor in pTis stage had metastasized to lymph nodes and only 9% of tumors in pT1 had metastasized.
  • Cases with early stage ampullary cancer of less than 2 cm with a well-differentiated histology and no angiolymphatic invasion (n = 13) showed no lymph node metastasis and no recurrence during a median follow up of 35.9 months.
  • CONCLUSION: Endoscopic papillectomy can be adopted as a viable alternative to surgery in patients with early stage ampullary cancer of less than 2 cm in size and with a well-differentiated histology.
  • [MeSH-major] Ampulla of Vater / surgery. Common Bile Duct Neoplasms / surgery. Endoscopy, Digestive System

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  • (PMID = 19032444.001).
  • [ISSN] 1440-1746
  • [Journal-full-title] Journal of gastroenterology and hepatology
  • [ISO-abbreviation] J. Gastroenterol. Hepatol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Australia
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13. Akatsu T, Aiura K, Takahashi S, Kameyama K, Kitajima M, Kitagawa Y: Signet-ring cell carcinoma of the ampulla of Vater: report of a case. Surg Today; 2007;37(12):1110-4
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Signet-ring cell carcinoma of the ampulla of Vater: report of a case.
  • Signet-ring cell carcinoma (SRCC) of the ampulla of Vater is uncommon, and only 13 cases have been previously described.
  • We herein report a rare case of a 43-year-old woman with SRCC in the ampulla of Vater.
  • Although this histologic type of cancer generally predicts a poor prognosis elsewhere in the gastrointestinal tract, the present patient has survived with no evidence of recurrence for 7.5 years.
  • She underwent a pancreaticoduodenectomy with an extended lymphadenectomy for ampullary carcinoma.
  • This neoplasm was classified as AcdbBi, 2.0 x 1.8 cm, ulcerative type, Panc(0), Du(2), T(2)N(0)M(-), Stage II according to the Japanese Classification on Cancer of the Biliary Tract.
  • Unfortunately, previous reports of ampullary SRCC have been limited to short-term follow-ups with a median period of only 12 months (range, 6-134 months), and long-term survival (more than 5 years) was only documented in two cases without lymph node metastasis (including the present case).
  • In conclusion, the experience gained in the present and previous cases suggests that long-term survival is possible following a curative resection in selected patients with ampullary SRCC without nodal involvement.
  • Due to the lack of sufficient evidence, additional reports are warranted to determine whether SRCC also portends a poor prognosis in patients with ampullary cancer.
  • [MeSH-major] Ampulla of Vater. Carcinoma, Signet Ring Cell / pathology. Common Bile Duct Neoplasms / pathology. Pancreaticoduodenectomy / methods
  • [MeSH-minor] Adult. Biopsy. Diagnosis, Differential. Female. Follow-Up Studies. Humans

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  • (PMID = 18030577.001).
  • [ISSN] 0941-1291
  • [Journal-full-title] Surgery today
  • [ISO-abbreviation] Surg. Today
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Japan
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14. Wu TC, Shao YF, Shan Y, Wu JX, Zhao DB, Xu LB, Zhao P: [Prognostic implication of common bile duct infiltration in adenocarcinoma of the ampulla of Vater after pancreaticoduodenectomy]. Zhonghua Zhong Liu Za Zhi; 2008 Oct;30(10):775-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Prognostic implication of common bile duct infiltration in adenocarcinoma of the ampulla of Vater after pancreaticoduodenectomy].
  • OBJECTIVE: To investigate the prognostic implication of common bile duct infiltration in the adenocarcinoma of the ampulla of Vater after panreaticoduodenectomy.
  • METHODS: A retrospective study was conducted on clinical manifestation, pathological behavior and survival data in 102 patients with Vater's ampulla adenocarcinoma, who underwent pancreaticoduodenectomy from Jan 1980 to Dec 2003.
  • RESULTS: There were 42 cases in stage I (41.2%), 32 in stage II (31.3%), 27 in stage III (26.5%), and 1 in stage IV (1.0%).
  • As for T stage: 9 cases in stage T1 (8.8%), 40 in T2 (39.2%), 25 in T3 (24.5%), and 28 in T4 (27.5%).
  • As regarding to N stage: 76 cases in stage N0 (74.5%) and 26 in N1 (25.5%).
  • CONCLUSION: If the adenocarcinoma of the Vater's ampulla infiltrated the common bile duct, the invasion to the pancreatic medulla is likely developed, and usually with a poor non-recurrence and overall survival.
  • [MeSH-major] Adenocarcinoma. Ampulla of Vater. Common Bile Duct / pathology. Common Bile Duct Neoplasms. Pancreaticoduodenectomy

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  • (PMID = 19173811.001).
  • [ISSN] 0253-3766
  • [Journal-full-title] Zhonghua zhong liu za zhi [Chinese journal of oncology]
  • [ISO-abbreviation] Zhonghua Zhong Liu Za Zhi
  • [Language] chi
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] China
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15. Krishnan S, Rana V, Evans DB, Varadhachary G, Das P, Bhatia S, Delclos ME, Janjan NA, Wolff RA, Crane CH, Pisters PW: Role of adjuvant chemoradiation therapy in adenocarcinomas of the ampulla of vater. Int J Radiat Oncol Biol Phys; 2008 Mar 1;70(3):735-43
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Role of adjuvant chemoradiation therapy in adenocarcinomas of the ampulla of vater.
  • PURPOSE: The role of adjuvant chemoradiation therapy (CRT) in the treatment of ampullary cancers remains undefined.
  • METHODS AND MATERIALS: Between May 1990 and January 2006, 54 of 96 patients with ampullary adenocarcinoma who underwent potentially curative pancreaticoduodenectomy also received adjuvant CRT.
  • However, on univariate analysis, T3/T4 tumor stage was prognostic for poorer LC and OS (p = 0.02 and p < 0.001, respectively); node-positive disease was prognostic for poorer LC (p = 0.03).
  • On multivariate analysis, T3/T4 tumor stage was independently prognostic for decreased OS (p = 0.002).
  • CONCLUSIONS: Ampullary cancers have a distinctly better treatment outcome than pancreatic adenocarcinomas.
  • Higher primary tumor stage (T3/T4), an independent adverse risk factor for poorer treatment outcomes, may warrant the addition of adjuvant CRT to pancreaticoduodenectomy.
  • [MeSH-major] Ampulla of Vater. Common Bile Duct Neoplasms / drug therapy. Common Bile Duct Neoplasms / radiotherapy

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  • (PMID = 17980502.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0W860991D6 / Deoxycytidine; 6804DJ8Z9U / Capecitabine; U3P01618RT / Fluorouracil
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16. Tang W, Guo Q, Usuda M, Kokudo N, Seyama Y, Minagawa M, Sugawara Y, Nakata M, Kojima N, Makuuchi M: Histochemical expression of sialoglycoconjugates in carcinoma of the papilla of Vater. Hepatogastroenterology; 2005 Jan-Feb;52(61):67-71

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Histochemical expression of sialoglycoconjugates in carcinoma of the papilla of Vater.
  • To investigate the role of sialylation in carcinoma of the papilla of Vater, histochemical analyses were performed using sialic acid-binding lectins, Maackia amurensis leukoagglutinin and Sambucus nigra agglutinin.
  • METHODOLOGY: Thirty-six papillary carcinoma tissues and 8 normal papillary tissues were subjected to lectin-histochemical staining.
  • Of 36 papillary carcinoma tissues, 20 showed Maackia amurensis leukoagglutinin-positive staining in cancer cells, whereas all 36 were Sambucus nigra agglutinin-positive in cancer cells.
  • Statistical analysis indicated that positive staining in cancer cells was frequent in cases of lymph node metastasis (p=0.001) and in cases classified > or = T2 by TNM classification (p=0.036).
  • CONCLUSIONS: Aberrant expression of sialoglycoconjugates recognized by Maackia amurensis leukoagglutinin might participate in lymph node metastasis and in an advanced stage of invasion in carcinoma of the papilla of Vater.
  • [MeSH-major] Ampulla of Vater / metabolism. Carcinoma / metabolism. Common Bile Duct Neoplasms / metabolism. Sialoglycoproteins / metabolism

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  • (PMID = 15782996.001).
  • [ISSN] 0172-6390
  • [Journal-full-title] Hepato-gastroenterology
  • [ISO-abbreviation] Hepatogastroenterology
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Greece
  • [Chemical-registry-number] 0 / Phytohemagglutinins; 0 / Plant Lectins; 0 / Sambucus nigra lectins; 0 / Sialoglycoproteins; 0 / leukoagglutinins, plants; EC 3.2.2.22 / Ribosome Inactivating Proteins
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17. Ruemmele P, Dietmaier W, Terracciano L, Tornillo L, Bataille F, Kaiser A, Wuensch PH, Heinmoeller E, Homayounfar K, Luettges J, Kloeppel G, Sessa F, Edmonston TB, Schneider-Stock R, Klinkhammer-Schalke M, Pauer A, Schick S, Hofstaedter F, Baumhoer D, Hartmann A: Histopathologic features and microsatellite instability of cancers of the papilla of vater and their precursor lesions. Am J Surg Pathol; 2009 May;33(5):691-704
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Histopathologic features and microsatellite instability of cancers of the papilla of vater and their precursor lesions.
  • The prevalence and development of microsatellite instability (MSI) and underlying mismatch repair (MMR) deficiency in the carcinogenesis of adenocarcinomas of the papilla of Vater and their precursor lesions are not well established.
  • We analyzed 120 ampullary adenomas (31 pure adenomas and 89 carcinoma-associated adenomas) and 170 pure adenocarcinomas for MSI, immunohistochemical expression of MMR proteins and specific histopathologic features.
  • Patients with MSI-H carcinoma had a significantly longer overall survival (P=0.0082) than those with MSI-L or MSS tumors.
  • Our findings indicate that the MSI-phenotype is an early event, which develops at the stage of adenoma and is reliably detectable in the precursor lesion.
  • The MMR deficient molecular pathway of carcinogenesis is associated with a histopathologic phenotype in ampullary cancer, similar to the one that has been well described in colon cancer.
  • [MeSH-major] Adenoma / pathology. Ampulla of Vater / pathology. Carcinoma / pathology. Common Bile Duct Neoplasms / pathology. DNA Mismatch Repair. Gene Expression Regulation, Neoplastic. Microsatellite Instability. Precancerous Conditions / pathology
  • [MeSH-minor] Adaptor Proteins, Signal Transducing / genetics. Adenocarcinoma / genetics. Adenocarcinoma / pathology. Adenocarcinoma, Mucinous / genetics. Adenocarcinoma, Mucinous / pathology. Adult. Aged. Aged, 80 and over. Carcinoma, Papillary / genetics. Carcinoma, Papillary / pathology. Cell Differentiation. DNA Methylation. DNA-Binding Proteins / genetics. Europe. Female. Gene Deletion. Genotype. Humans. Immunohistochemistry. Kaplan-Meier Estimate. Male. Middle Aged. MutS Homolog 2 Protein / genetics. Neoplasm Invasiveness. Neoplasm Staging. Nuclear Proteins / genetics. Phenotype. Polymerase Chain Reaction. Promoter Regions, Genetic. Proportional Hazards Models. Risk Assessment. Treatment Outcome

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  • (PMID = 19252434.001).
  • [ISSN] 1532-0979
  • [Journal-full-title] The American journal of surgical pathology
  • [ISO-abbreviation] Am. J. Surg. Pathol.
  • [Language] eng
  • [Publication-type] Journal Article; Multicenter Study
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Adaptor Proteins, Signal Transducing; 0 / DNA-Binding Proteins; 0 / G-T mismatch-binding protein; 0 / MLH1 protein, human; 0 / Nuclear Proteins; EC 3.6.1.3 / MSH2 protein, human; EC 3.6.1.3 / MutS Homolog 2 Protein
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18. Lu ZC, Guo JM, Zhang YL, Tian PL, Zhang L, Yu JP, Bao XY: [Comparison of endoscopic ultrasonography with computer-assisted tomography in the determination of preoperative stage and resectability of pancreatic and ampullary cancers]. Zhonghua Zhong Liu Za Zhi; 2006 Jun;28(6):441-4
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  • [Title] [Comparison of endoscopic ultrasonography with computer-assisted tomography in the determination of preoperative stage and resectability of pancreatic and ampullary cancers].
  • OBJECTIVE: To study and compare the accuracy and sensitivity of endoscopic ultrasonography (EUS) and CT scaning in determination of preoperative stage and vascular invasion by pancreatic and ampullary cancers.
  • METHODS: Fourty-two pancreatic cancer patients and 18 ampullary cancer patients were studied.
  • The structures of each part of pancreatic head and ampullary together with surrounding vessels were scanned.
  • 1996 to May 2004, a total of 42 pancreatic cancer patients and 18 ampullary cancer patients were examined by EUS.
  • The results of stage and vascular invasion determined by EUS in this series were as following; pancreatic cancer group (n = 42): accuracy in T2-4 stage was 100.0% (5/5), 75.0% (9/12) and 48.0% (12/25), respectively; ampullary cancer group (n = 18): T1-4 stage was 75.0% (3/4), 66.7% (2/3), 75.0% (6/8) and 33.3% (1/3), respectively; the accuracy in N stage: P-group: 80.0% in N1 (4/5), 90.0% in N0 (9/10); A-group: 50.0% in N1 (3/6), 91.0% in N0 (10/11).
  • CONCLUSION: Endoscopic ultrosonography being one of the best image examinations to determine the stage and vascular invasion for pancreatic and ampullary cancer paitients is able to detect small pancreatic or ampullary cancer less than 2.0 cm in diameter due to its high resolution; but can not detect the secondary multiple distal metastases such as spread into the liver, peritonium or hepatoduodenal ligament, etc. due to its ultrasound depth limitation.
  • [MeSH-major] Ampulla of Vater / ultrasonography. Common Bile Duct Neoplasms / ultrasonography. Endosonography. Pancreas / ultrasonography. Pancreatic Neoplasms / ultrasonography

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  • (PMID = 17152491.001).
  • [ISSN] 0253-3766
  • [Journal-full-title] Zhonghua zhong liu za zhi [Chinese journal of oncology]
  • [ISO-abbreviation] Zhonghua Zhong Liu Za Zhi
  • [Language] chi
  • [Publication-type] Comparative Study; English Abstract; Journal Article
  • [Publication-country] China
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19. Oh SY, Lee GW, Kim HG, Kim TH, Kim HJ, Kang JH: Phase II trial of S-1 in combination with oxaliplatin in previously untreated patients with recurrent or inoperable biliary tract cancer. Chemotherapy; 2008;54(6):479-84
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Phase II trial of S-1 in combination with oxaliplatin in previously untreated patients with recurrent or inoperable biliary tract cancer.
  • RESULTS: 15 patients were enrolled: 9 patients (60%) had intrahepatic and 3 (20%) had extrahepatic cholangiocarcinoma, 2 (13.3%) had cancer of the ampulla of Vater and 1 patient had gall bladder cancer.
  • As the response rate in stage I did not justify progression to stage II (> or =2/15), this study had to be discontinued in accordance with the established protocols.

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  • [Copyright] 2008 S. Karger AG, Basel.
  • (PMID = 18832821.001).
  • [ISSN] 1421-9794
  • [Journal-full-title] Chemotherapy
  • [ISO-abbreviation] Chemotherapy
  • [Language] eng
  • [Publication-type] Clinical Trial, Phase II; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Switzerland
  • [Chemical-registry-number] 0 / Drug Combinations; 0 / Organoplatinum Compounds; 04ZR38536J / oxaliplatin; 150863-82-4 / S 1 (combination); 1548R74NSZ / Tegafur; 5VT6420TIG / Oxonic Acid
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20. Hsu HP, Shan YS, Lai MD, Lin PW: Osteopontin-positive infiltrating tumor-associated macrophages in bulky ampullary cancer predict survival. Cancer Biol Ther; 2010 Jul 15;10(2):144-54
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Osteopontin-positive infiltrating tumor-associated macrophages in bulky ampullary cancer predict survival.
  • PURPOSE: Tumor-associated macrophages (TAMs) promote cancer cell proliferation and distant metastases.
  • Osteopontin (OPN) is overexpressed in several human cancer cells and in TAMs.
  • Therefore, we set out to determine the role of OPN-expressing macrophages in cancer.
  • RESULTS: In 100 ampullary cancers, diffuse cytoplasmic positivity for OPN was found in infiltrating TAMs in 36 patients and marginal TAMs in 32 patients; OPN(+) macrophages were absent in 32 patients.
  • Expression patterns of OPN in TAMs were associated with pancreatic invasion, tumor stage, TNM stage, lymphovascular invasion and recurrence with peritoneal carcinomatosis.
  • Macrophage-associated cytokine expression in ampullary cancer cells was also assessed; levels of macrophage migration inhibitory factor (MIF) in cancer cells were higher than in normal duodenal mucosa.
  • EXPERIMENTAL DESIGN: Specimens from ampullary cancer patients at National Cheng Kung University Hospital were collected for immunohistochemistry.
  • CONCLUSIONS: Expression of OPN and location of TAMs in bulky ampullary cancer predict recurrence.
  • In addition, cytoplasmic staining of MIF is enhanced in ampullary cancer cells.
  • [MeSH-major] Adenocarcinoma / pathology. Ampulla of Vater / pathology. Biomarkers, Tumor / metabolism. Common Bile Duct Neoplasms / pathology. Macrophage Migration-Inhibitory Factors / metabolism. Macrophages / metabolism. Osteopontin / metabolism. RNA, Neoplasm / metabolism

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  • (PMID = 20495367.001).
  • [ISSN] 1555-8576
  • [Journal-full-title] Cancer biology & therapy
  • [ISO-abbreviation] Cancer Biol. Ther.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / Macrophage Migration-Inhibitory Factors; 0 / RNA, Neoplasm; 106441-73-0 / Osteopontin
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21. van Oost FJ, Luiten EJ, van de Poll-Franse LV, Coebergh JW, van den Eijnden-van Raaij AJ: Outcome of surgical treatment of pancreatic, peri-ampullary and ampullary cancer diagnosed in the south of The Netherlands: a cancer registry based study. Eur J Surg Oncol; 2006 Jun;32(5):548-52
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Outcome of surgical treatment of pancreatic, peri-ampullary and ampullary cancer diagnosed in the south of The Netherlands: a cancer registry based study.
  • AIMS: To gain insight into the quality of pancreatic cancer surgery in 10 low-volume (median sized) hospitals, each serving 150,000-250,000 people, in the Comprehensive Cancer Centre South (CCCS) area and of referred patients to academic centres to determine the need for further regionalization.
  • METHOD: The population-based Eindhoven Cancer Registry was used to select all patients in the CCCS area with pancreatic, peri-ampullary and ampullary cancer diagnosed between January 1, 1995 and April 30, 2000 (N = 1130).
  • RESULTS: For all pancreatic carcinoma resections, the 3-month survival rate was 82%, varying from 95% for referred patients to 76% for patients treated within the region (p = 0.014).
  • Surgically treated patients who were referred to university hospitals outside the CCCS area were younger, more often male, more often diagnosed with pTNM stage III, exhibited less comorbidity and had a higher socio-economic status than patients surgically treated within the region.
  • [MeSH-major] Ampulla of Vater / surgery. Carcinoma / surgery. Common Bile Duct Neoplasms / surgery. Pancreatic Neoplasms / surgery. Registries

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  • (PMID = 16569495.001).
  • [ISSN] 0748-7983
  • [Journal-full-title] European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
  • [ISO-abbreviation] Eur J Surg Oncol
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
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22. Uchida H, Shibata K, Iwaki K, Kai S, Ohta M, Kitano S: Ampullary cancer and preoperative jaundice: possible indication of the minimal surgery. Hepatogastroenterology; 2009 Jul-Aug;56(93):1194-8

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Ampullary cancer and preoperative jaundice: possible indication of the minimal surgery.
  • BACKGROUND/AIMS: Obstructive jaundice is common symptom of carcinoma of the ampulla of Vater.
  • Preoperative jaundice, serum carbohydrate antigen 19-9 level, pancreatic invasion, lymphatic invasion, venous invasion, perineural invasion, duodenal invasion, margin status, lymph node metastasis, and T stage were shown to be significant prognostic factors.
  • In addition, 12 of the 14 patients without jaundice and lymphatic invasion were diagnosed as T1N0 (stage IA) disease, and all the tumors were papillary or well-differentiated adenocarcinoma.
  • CONCLUSIONS: Preoperative jaundice may reflect advanced-stage in case of ampullary cancer.
  • [MeSH-major] Adenocarcinoma / surgery. Ampulla of Vater / pathology. Common Bile Duct Neoplasms / surgery. Jaundice, Obstructive / surgery

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  • (PMID = 19760968.001).
  • [ISSN] 0172-6390
  • [Journal-full-title] Hepato-gastroenterology
  • [ISO-abbreviation] Hepatogastroenterology
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Greece
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23. Milsmann C, Füzesi L, Werner C, Becker H, Horstmann O: [Significance of occult lymphatic tumor spread in pancreatic cancer]. Chirurg; 2005 Nov;76(11):1064-72
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Significance of occult lymphatic tumor spread in pancreatic cancer].
  • PURPOSE: The aim of this study was to determine the frequency and effect on prognosis of occult tumor cells in regional lymph nodes judged to be tumor-free in conventional histopathology of pancreatic cancer patients.
  • PATIENTS AND METHODS: Among 115 patients who underwent pancreatic resection for pancreatic (n=84) or distal common bile duct malignancy (n=12) or carcinoma of the papilla (n=19), 48 (42%) were staged pN0.
  • The occurrence of occult tumor cells was not dependent on other clinicopathological factors such as pT stage, grading, or curative resection.
  • CONCLUSION: Occult tumor cells are frequent in apparently tumor-free lymph nodes of pancreatic cancer patients and often overlooked in conventional histopathology.
  • Occult tumor cells in lymph nodes of pancreatic cancer patients could be used to stratify adjuvant therapy.
  • [MeSH-major] Ampulla of Vater / surgery. Carcinoma, Ductal / surgery. Common Bile Duct Neoplasms / surgery. Lymph Node Excision. Lymphatic Metastasis / pathology. Pancreatectomy. Pancreatic Neoplasms / surgery

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  • (PMID = 15971035.001).
  • [ISSN] 0009-4722
  • [Journal-full-title] Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen
  • [ISO-abbreviation] Chirurg
  • [Language] ger
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Germany
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24. Hsu HP, Yang TM, Hsieh YH, Shan YS, Lin PW: Predictors for patterns of failure after pancreaticoduodenectomy in ampullary cancer. Ann Surg Oncol; 2007 Jan;14(1):50-60

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Predictors for patterns of failure after pancreaticoduodenectomy in ampullary cancer.
  • BACKGROUND: Ampullary cancer has the best prognosis in periampullary malignancy but unpredicted early recurrence after resection is frequent.
  • METHODS: Information was collected from patients who underwent pancreaticoduodenectomy with regional lymphadenectomy for ampullary cancer in high-volume hospitals between January 1989 and April 2005.
  • The 5-year disease-specific survival rate was 45.7%; 77.7% for stage I, 28.5% for stage II, and 16.5% for stage III; and 63.7% for node-negative versus 19.1% for node-positive patients.
  • Pancreatic invasion and lymph node involvement were both predictors for survival of patients with ampullary cancer.
  • CONCLUSION: Pancreaticoduodenectomy with regional lymphadenectomy is adequate for early-stage ampullary cancer but a dismal outcome can be predicted in patients with lymph node metastasis and pancreatic invasion.
  • [MeSH-major] Ampulla of Vater. Common Bile Duct Neoplasms / surgery. Pancreaticoduodenectomy

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  • (PMID = 17054003.001).
  • [ISSN] 1068-9265
  • [Journal-full-title] Annals of surgical oncology
  • [ISO-abbreviation] Ann. Surg. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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25. Ajki T, Fujita T, Matsumoto I, Yasuda T, Fujino Y, Ueda T, Suzuki Y, Kuroda Y, Ku Y: Diagnostic and prognostic value of peritoneal cytology in biliary tract cancer. Hepatogastroenterology; 2008 May-Jun;55(84):842-5
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Diagnostic and prognostic value of peritoneal cytology in biliary tract cancer.
  • METHODOLOGY: A total of consecutive 41 patients with biliary cancers (17 bile duct, 20 gallbladder, 4 ampulla of Vater) underwent surgery between July 2003 and July 2005.
  • When analyzed by disease factors or stage, the prevalence of positive cytology was 0% in T1/T2, 6% in T3, 38% in T4 (p=0.03), 0% in N0, 25% in N1 (p=.03), 3% in M0, 27% in M1 (p=0.02), 0% in Stage I/II and 27% in Stage III/IV cases (p<0.01), respectively.
  • Although survival was worse in patients with positive peritoneal cytology, when adjusting TNM stage the positive peritoneal cytology did not have significant prognostic value.

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  • (PMID = 18705279.001).
  • [ISSN] 0172-6390
  • [Journal-full-title] Hepato-gastroenterology
  • [ISO-abbreviation] Hepatogastroenterology
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Greece
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26. Winter JM, Cameron JL, Olino K, Herman JM, de Jong MC, Hruban RH, Wolfgang CL, Eckhauser F, Edil BH, Choti MA, Schulick RD, Pawlik TM: Clinicopathologic analysis of ampullary neoplasms in 450 patients: implications for surgical strategy and long-term prognosis. J Gastrointest Surg; 2010 Feb;14(2):379-87
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Clinicopathologic analysis of ampullary neoplasms in 450 patients: implications for surgical strategy and long-term prognosis.
  • BACKGROUND: Whether ampullary neoplasms are best surgically managed by pancreaticoduodenectomy versus local ampullectomy is controversial.
  • We sought to examine the outcome of patients undergoing pancreaticoduodenectomy versus ampullectomy, as well as to identify factors predictive of lymph node metastasis in patients with ampullary neoplasms.
  • METHODS: Between 1970 and 2007, 450 patients who underwent surgical resection of ampullary adenoma or adenocarcinoma were identified from a prospective, single-institution database.
  • Final diagnosis was invasive adenocarcinoma (77.1%) or adenoma (22.9%).
  • Median tumor size was similar for adenomas associated with an adenocarcinoma (2.5 cm) versus adenomas without invasive cancer (2.9 cm; P=0.71).
  • Specifically, risk of lymph node metastasis increased with T stage (T1, 28.0%; T2, 50.9%; T3, 71.7%; T4, 77.3%; P<0.001).
  • CONCLUSION: When surgery is indicated, radical resection is required for early invasive adenocarcinoma of the ampulla of Vater, as lymph node metastases are present in nearly 30% of patients with T1 disease.
  • Pancreaticoduodenectomy should be the preferred approach for most ampullary neoplasms that require surgical resection.
  • [MeSH-major] Adenocarcinoma / surgery. Adenoma / surgery. Ampulla of Vater / surgery. Common Bile Duct Neoplasms / surgery

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  • (PMID = 19911239.001).
  • [ISSN] 1873-4626
  • [Journal-full-title] Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract
  • [ISO-abbreviation] J. Gastrointest. Surg.
  • [Language] eng
  • [Grant] United States / NCRR NIH HHS / RR / 1KL2RR025006-01
  • [Publication-type] Comparative Study; Journal Article; Research Support, N.I.H., Extramural
  • [Publication-country] United States
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27. Warnecke-Eberz U, Prenzel KL, Baldus SE, Metzger R, Dienes HP, Bollschweiler E, Hoelscher AH, Schneider PM: Significant down-regulation of the plasminogen activator inhibitor 1 mRNA in pancreatic cancer. Pancreas; 2008 Mar;36(2):173-7
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Significant down-regulation of the plasminogen activator inhibitor 1 mRNA in pancreatic cancer.
  • OBJECTIVES: We examined mRNA expression of the urokinase-type plasminogen activator (uPA), its receptor (uPAR), and the plasminogen activator inhibitor 1 (PAI-1) in a panel of adenocarcinomas of the pancreas (PC) and cancers of the papilla of Vater (CPV).
  • Expression levels of the 3 genes were not associated with tumor stage, grading, or survival.
  • [MeSH-major] Adenocarcinoma / genetics. Ampulla of Vater / pathology. Common Bile Duct Neoplasms / genetics. Gene Expression Regulation, Neoplastic. Pancreatic Neoplasms / genetics. Plasminogen Activator Inhibitor 1 / genetics. RNA, Messenger / analysis

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  • (PMID = 18376309.001).
  • [ISSN] 1536-4828
  • [Journal-full-title] Pancreas
  • [ISO-abbreviation] Pancreas
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / PLAUR protein, human; 0 / Plasminogen Activator Inhibitor 1; 0 / RNA, Messenger; 0 / Receptors, Cell Surface; 0 / Receptors, Urokinase Plasminogen Activator; 0 / SERPINE1 protein, human; EC 3.4.21.73 / Urokinase-Type Plasminogen Activator
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28. Goodman MT, Yamamoto J: Descriptive study of gallbladder, extrahepatic bile duct, and ampullary cancers in the United States, 1997-2002. Cancer Causes Control; 2007 May;18(4):415-22
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Descriptive study of gallbladder, extrahepatic bile duct, and ampullary cancers in the United States, 1997-2002.
  • OBJECTIVE: Few investigations of biliary tract (gallbladder, extrahepatic bile duct, ampulla of Vater) cancers have been conducted because of the relative rarity of these malignancies.
  • RESULTS: The AAIR for gallbladder cancer among men (0.82 per 100,000) was significantly lower than the AAIR among women (1.45 per 100,000).
  • By contrast, rates for extrahepatic bile duct and ampullary cancers were significantly higher among men (0.93 per 100,000 and 0.70 per 100,000, respectively) than among women (0.61 per 100,000 and 0.45 per 100,000, respectively).
  • White men and women had significantly lower AAIRs for gallbladder cancer compared with other racial-ethnic groups, with the highest rates among Hispanics, American Indian-Alaska Natives, and Asian-Pacific Islanders.
  • Asian-Pacific Islanders and Hispanics of both sexes had the highest AAIRs for extrahepatic bile duct and ampullary cancers.
  • Ampullary tumors were more likely to be diagnosed at a localized or regional stage than were cancers of the gallbladder and extrahepatic bile duct.
  • CONCLUSIONS: This population-based study suggests distinct etiologies of anatomic subsites of biliary tract cancer and caution against analytic investigations of all biliary tract cancers combined.
  • [MeSH-major] Ampulla of Vater / pathology. Bile Duct Neoplasms / epidemiology. Gallbladder Neoplasms / epidemiology

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  • (PMID = 17264972.001).
  • [ISSN] 0957-5243
  • [Journal-full-title] Cancer causes & control : CCC
  • [ISO-abbreviation] Cancer Causes Control
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CN / N01-CN-67001; United States / PHS HHS / / U75/CCU515998
  • [Publication-type] Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] Netherlands
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29. Woo SM, Ryu JK, Lee SH, Yoo JW, Park JK, Kim YT, Jang JY, Kim SW, Kang GH, Yoon YB: Recurrence and prognostic factors of ampullary carcinoma after radical resection: comparison with distal extrahepatic cholangiocarcinoma. Ann Surg Oncol; 2007 Nov;14(11):3195-201

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Recurrence and prognostic factors of ampullary carcinoma after radical resection: comparison with distal extrahepatic cholangiocarcinoma.
  • BACKGROUND: Ampullary carcinoma is often considered to have a better prognosis than distal extrahepatic cholangiocarcinoma.
  • METHODS: Clinicopathologic factors and the long-term outcomes of 163 patients with ampullary carcinoma after radical resection were retrospectively evaluated and compared with those of 91 patients with distal extrahepatic cholangiocarcinoma.
  • RESULTS: Among the 163 ampullary carcinomas, T1 stage, well-differentiated tumors and perineural invasion were 45 (28%), 73 (45%), and 23 (14%), respectively, whereas, only five (6%) were T1 stage, 15 (17%) were well differentiated, and 63 (69%) showed perineural invasion (p < 0.001, for all) in distal extrahepatic cholangiocarcinomas.
  • More patients with distal extrahepatic cholangiocarcinoma had liver metastasis than ampullary carcinoma (24% vs. 10%, p = 0.004).
  • Multivariate analysis identified venous invasion and perineural invasion as risk factors for recurrence of ampullary carcinoma after radical resection.
  • Overall five-year survival of patients with ampullary cancer was higher than that of patients with distal extrahepatic cholangiocarcinoma (68% vs. 54%; p = 0.033).
  • CONCLUSION: Earlier diagnosis and the less frequent occurrence of pathological factors associated with tumor invasiveness in ampullary carcinoma than in distal extrahepatic cholangiocarcinoma may explain its association with a better prognosis.
  • [MeSH-major] Ampulla of Vater / pathology. Bile Ducts, Extrahepatic / pathology. Cholangiocarcinoma / pathology. Common Bile Duct Neoplasms / pathology. Neoplasm Recurrence, Local / diagnosis

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  • (PMID = 17710498.001).
  • [ISSN] 1534-4681
  • [Journal-full-title] Annals of surgical oncology
  • [ISO-abbreviation] Ann. Surg. Oncol.
  • [Language] eng
  • [Publication-type] Clinical Trial; Comparative Study; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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30. Roggin KK, Yeh JJ, Ferrone CR, Riedel E, Gerdes H, Klimstra DS, Jaques DP, Brennan MF: Limitations of ampullectomy in the treatment of nonfamilial ampullary neoplasms. Ann Surg Oncol; 2005 Dec;12(12):971-80
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Limitations of ampullectomy in the treatment of nonfamilial ampullary neoplasms.
  • BACKGROUND: Pancreaticoduodenectomy (PD) is the standard surgical management of invasive ampullary neoplasms.
  • METHODS: We identified 140 consecutive cases of nonfamilial ampullary neoplasms from our prospective institutional database over a 7-year period (1996-2003).
  • AMP was converted to PD because of the extent of disease in three and an intraoperative diagnosis of invasive cancer in five patients.
  • Intraoperative frozen section had a diagnostic accuracy of 84%; two cases of high-grade dysplasia and invasive cancer were missed.
  • Patients with invasive cancer treated by AMP had a decreased recurrence-free and disease-specific survival compared with those treated by PD.
  • Although both vascular invasion and tumor stage independently predicted lymphatic metastases, both were limited by their sensitivity.
  • CONCLUSIONS: The reduced morbidity and mortality of AMP makes this the preferred treatment for benign lesions of the ampulla.
  • [MeSH-major] Ampulla of Vater / surgery. Pancreatic Neoplasms / surgery

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  • [CommentIn] Ann Surg Oncol. 2005 Dec;12(12):955-6 [16228813.001]
  • (PMID = 16244798.001).
  • [ISSN] 1068-9265
  • [Journal-full-title] Annals of surgical oncology
  • [ISO-abbreviation] Ann. Surg. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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31. Franko J, Krasinskas AM, Nikiforova MN, Zarnescu NO, Lee KK, Hughes SJ, Bartlett DL, Zeh HJ 3rd, Moser AJ: Loss of heterozygosity predicts poor survival after resection of pancreatic adenocarcinoma. J Gastrointest Surg; 2008 Oct;12(10):1664-72; discussion 1672-3
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • BACKGROUND: American Joint Committee on Cancer (AJCC) staging for pancreatic adenocarcinoma is a validated predictor of prognosis but insufficiently discriminates postresection survival.
  • METHODS: Resected pancreatic ductal and ampullary adenocarcinomas (n = 50) were analyzed for loss of heterozygosity (LOH) at 15 markers including 5q(APC), 6q(TBSP2), 9p(p16), 10q(PTEN), 12q(MDM2), 17p(TP53), and 18q(DCC/SMAD4).
  • AJCC stage was: Ia/b (3), IIa (16), IIb (31).
  • Stage, nodal and margin status were not predictive of survival.
  • CONCLUSION: LOH and KRAS mutations indicate aggressive tumor biology and correlate strongly with survival in resected pancreatic ductal and ampullary carcinomas.
  • [MeSH-major] Adenocarcinoma / genetics. Ampulla of Vater. Common Bile Duct Neoplasms / genetics. Loss of Heterozygosity. Pancreatic Neoplasms / genetics
  • [MeSH-minor] Aged. Aged, 80 and over. Carcinoma, Pancreatic Ductal / genetics. Carcinoma, Pancreatic Ductal / surgery. Female. Genes, Tumor Suppressor. Humans. Male. Middle Aged. Mutation. Pancreatectomy. Pilot Projects. Predictive Value of Tests. Prognosis. Proto-Oncogene Proteins / genetics. Retrospective Studies. Survival Analysis. ras Proteins / genetics

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  • (PMID = 18677542.001).
  • [ISSN] 1873-4626
  • [Journal-full-title] Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract
  • [ISO-abbreviation] J. Gastrointest. Surg.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / KRAS protein, human; 0 / Proto-Oncogene Proteins; EC 3.6.5.2 / ras Proteins
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32. Ni XG, Bai XF, Mao YL, Shao YF, Wu JX, Shan Y, Wang CF, Wang J, Tian YT, Liu Q, Xu DK, Zhao P: The clinical value of serum CEA, CA19-9, and CA242 in the diagnosis and prognosis of pancreatic cancer. Eur J Surg Oncol; 2005 Mar;31(2):164-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] The clinical value of serum CEA, CA19-9, and CA242 in the diagnosis and prognosis of pancreatic cancer.
  • AIM: Serum tumour markers carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9) and CA242 were investigated to evaluate the values of single and combined test in the diagnosis and prognosis of pancreatic cancer.
  • RESULTS: The sensitivity of CA19-9 alone was the highest in pancreatic cancer patients (80%), but the specificity was significantly lower than that of CEA and CA242 (P<0.01).
  • CONCLUSION: The diagnostic rate of CA19-9 in pancreatic cancer is better than that of CEA and CA242.
  • High levels of serum markers are associated with advanced stage of the disease.
  • [MeSH-major] Antigens, Tumor-Associated, Carbohydrate / blood. Biomarkers, Tumor / blood. CA-19-9 Antigen / blood. Carcinoembryonic Antigen / blood. Carcinoma, Islet Cell / blood. Carcinoma, Islet Cell / diagnosis. Pancreatic Neoplasms / blood. Pancreatic Neoplasms / diagnosis
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Ampulla of Vater / metabolism. Ampulla of Vater / pathology. Bile Duct Neoplasms / blood. Bile Duct Neoplasms / diagnosis. Bile Duct Neoplasms / surgery. Bile Ducts, Extrahepatic / metabolism. Bile Ducts, Extrahepatic / pathology. Bilirubin / blood. Cholangiocarcinoma / blood. Cholangiocarcinoma / diagnosis. Cholangiocarcinoma / surgery. Female. Humans. Male. Middle Aged. Neoplasm Staging. Pancreaticoduodenectomy. Prognosis. Sensitivity and Specificity. Statistics as Topic. Survival Analysis. Treatment Outcome

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  • (PMID = 15698733.001).
  • [ISSN] 0748-7983
  • [Journal-full-title] European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
  • [ISO-abbreviation] Eur J Surg Oncol
  • [Language] eng
  • [Publication-type] Comparative Study; Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antigens, Tumor-Associated, Carbohydrate; 0 / Biomarkers, Tumor; 0 / CA 242 antigen; 0 / CA-19-9 Antigen; 0 / Carcinoembryonic Antigen; RFM9X3LJ49 / Bilirubin
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33. Vincenzi B, Santini D, Perrone G, Russo A, Adamo V, Rizzo S, Castri F, Antinori A, Alloni R, Crucitti PF, Morini S, Rabitti C, Vecchio FM, Magistrelli P, Coppola R, Tonini G: Promyelocytic leukemia (PML) gene expression is a prognostic factor in ampullary cancer patients. Ann Oncol; 2009 Jan;20(1):78-83

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Promyelocytic leukemia (PML) gene expression is a prognostic factor in ampullary cancer patients.
  • PATIENTS AND METHODS: In all, 62 ampullary adenocarcinoma patients who underwent curative surgery between 1996 and 2005 were included.
  • By univariate analysis, DFS was significantly influenced by pathological T stage (P=0.03), lymph nodal involvement (P=0.002), and PML expression (P=0.001).
  • CONCLUSIONS: Our preliminary data suggest PML as a novel prognostic tool for ampullary cancer patients.

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  • (PMID = 18689862.001).
  • [ISSN] 1569-8041
  • [Journal-full-title] Annals of oncology : official journal of the European Society for Medical Oncology
  • [ISO-abbreviation] Ann. Oncol.
  • [Language] ENG
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / Nuclear Proteins; 0 / Transcription Factors; 0 / Tumor Suppressor Proteins; 143220-95-5 / PML protein, human
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34. Ohike N, Coban I, Kim GE, Basturk O, Tajiri T, Krasinskas A, Bandyopadhyay S, Morohoshi T, Shimada Y, Kooby DA, Staley CA, Goodman M, Adsay NV: Tumor budding as a strong prognostic indicator in invasive ampullary adenocarcinomas. Am J Surg Pathol; 2010 Oct;34(10):1417-24
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Tumor budding as a strong prognostic indicator in invasive ampullary adenocarcinomas.
  • Prognostication of invasive ampullary adenocarcinomas (AACs) and their stratification into appropriate management categories have been highly challenging owing to a lack of well-established predictive parameters.
  • In colorectal cancers, recent studies have shown that tumor budding confers a worse prognosis and correlates significantly with nodal metastasis and recurrence; however, this has not been evaluated in AAC.To investigate the prevalence, significance, and clinical correlations of tumor budding in AAC, 244 surgically resected, stringently defined, invasive AAC were analyzed for tumor budding---defined as the presence of more than or equal to 5 isolated single cancer cells or clusters composed of fewer than 5 cancer cells per field measuring 0.785 mm using a 20× objective lens in the stroma of the invasive front.
  • When the clinicopathologic features and survival of the 2 groups were compared, the AACs with high-budding had larger invasion size (19 mm vs. 13 mm; P<0.001), an unrecognizable/absent preinvasive component (57% vs. 82%; P<0.005), infiltrative growth (51% vs. 2%; P<0.001), nonintestinal-type histology (72% vs. 46%; P<0.001), worse differentiation (58% vs. 10%; P<0.001), more lymphatic (74% vs. 10%; P<0.001), and perineural invasion (28% vs. 2%; P<0.001); more lymph node metastasis (44% vs. 17%; P<0.001), higher T-stage (T3 and T4) (42% vs. 10%; P<0.001), and more aggressive behavior (mean survival: 50 mo vs. 32 mo; 3-year and 5-year survival rates: 93% vs. 41% and 68% vs. 24%, respectively; P<0.001).
  • Furthermore, using a multivariable Cox regression model, tumor budding was found to be an independent predictor of survival (P=0.01), which impacts prognosis (hazard ratio: 2.6) even more than T-stage and lymph node metastasis (hazard ratio: 1.9 and 1.8, respectively).In conclusion, tumor budding is frequently encountered in AAC.
  • High-budding is a strong independent predictor of overall survival, with a prognostic correlation stronger than the 2 established parameters: T-stage and lymph node metastasis.

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  • (PMID = 20871215.001).
  • [ISSN] 1532-0979
  • [Journal-full-title] The American journal of surgical pathology
  • [ISO-abbreviation] Am. J. Surg. Pathol.
  • [Language] ENG
  • [Grant] United States / NCI NIH HHS / CA / P50 CA062924; United States / NCI NIH HHS / CA / CA088273-01; United States / NCI NIH HHS / CA / P50 CA062924-18; United States / NCI NIH HHS / CA / P20 CA101936; United States / NCI NIH HHS / CA / R03 CA088273; United States / NCI NIH HHS / CA / CA101936; United States / NCI NIH HHS / CA / R03 CA088273-01
  • [Publication-type] Journal Article; Multicenter Study; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Other-IDs] NLM/ NIHMS315768; NLM/ PMC3163902
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35. Kawaguchi T, Ochiai T, Ikoma H, Inoue K, Morimura R, Murayama Y, Komatsu S, Shiozaki A, Kuriu Y, Nakanishi M, Ichikawa D, Okamoto K, Fujiwara H, Kokuba Y, Sonoyama T, Otsuji E: Prognostic impact of histological blood vessel invasion in patients with ampullary adenocarcinoma. Hepatogastroenterology; 2010 Nov-Dec;57(104):1347-50

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Prognostic impact of histological blood vessel invasion in patients with ampullary adenocarcinoma.
  • BACKGROUNDS/AIMS: Ampullary adenocarcinoma (AmpCA) has a greater overall survival (OS) rate than other periampullary cancers such as pancreatic cancer or bile duct cancer.
  • Of the 28 patients, nine (32%) were > or = T3 tumors and nine (32%) were pN1 stage.
  • [MeSH-major] Adenocarcinoma / pathology. Adenocarcinoma / surgery. Ampulla of Vater / pathology. Common Bile Duct Neoplasms / pathology. Common Bile Duct Neoplasms / surgery. Vascular Neoplasms / pathology

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  • (PMID = 21443083.001).
  • [ISSN] 0172-6390
  • [Journal-full-title] Hepato-gastroenterology
  • [ISO-abbreviation] Hepatogastroenterology
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Greece
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36. Chang YT, Hsu C, Jeng YM, Chang MC, Wei SC, Wong JM: Expression of the caudal-type homeodomain transcription factor CDX2 is related to clinical outcome in biliary tract carcinoma. J Gastroenterol Hepatol; 2007 Mar;22(3):389-94

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Expression of the caudal-type homeodomain transcription factor CDX2 is related to clinical outcome in biliary tract carcinoma.
  • Recent studies have reported that expression of CDX2 was an independent marker of outcome in patients with resected adenocarcinoma of ampulla of Vater, gastric cancer, and colon cancer.
  • The clinicopathological significance of CDX2 expression has hitherto remained unclear in biliary tract carcinoma (BTC).
  • The correlation between expression of CDX2 and clinicopathological factors, including overall survival, tumor location, tumor stage, and degree of tumor differentiation, was examined in patients with BTC.
  • Factors influencing survival on univariate analysis were tumor stage (P < 0.00001), degree of tumor differentiation (P = 0.0002), and CDX2 expression (P = 0.01).
  • On multivariate analysis using the Cox proportional hazard model, CDX2 expression and tumor stage were independent prognostic factors in patients with BTC.
  • CONCLUSION: Expression of CDX2 was an independent indicator of outcome in patients with BTC in addition to tumor stage and tumor differentiation.
  • The mechanism by which CDX2 expression influences behavior of biliary tract carcinoma needs further investigation.
  • [MeSH-major] Biliary Tract Neoplasms / metabolism. Carcinoma / metabolism. Homeodomain Proteins / biosynthesis. Trans-Activators / biosynthesis

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  • (PMID = 17295772.001).
  • [ISSN] 0815-9319
  • [Journal-full-title] Journal of gastroenterology and hepatology
  • [ISO-abbreviation] J. Gastroenterol. Hepatol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Australia
  • [Chemical-registry-number] 0 / Homeodomain Proteins; 0 / Trans-Activators; 156560-97-3 / Cdx-2-3 protein
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