RADICAL RESECTION FOR AMPULLARY CARCINOMA - LONG-TERM RESULTS

Of 36 patients with carcinoma of the ampulla of Vater who underwent su rgery between 1971 and 1990, 31 had a radical operation. There was one operative death. The overall 5- and 10-year survival rates were 56 an d 37 per cent respectively. Survival was significantly influenced by t umour stage (P=0.0002), lymph node status (P=0.006) and the degree of differentiation of the lesion (P=0.01). Three patients developed local recurrence after local excision of the tumour. Local or hepatic recur rence was common, even 5 years after pancreatoduodenectomy (four of 18 patients who suffered relapse). Radical resection can be curative in selected patients with ampullary carcinoma but late recurrence suggest s the need for careful lifelong follow-up.