HYPOTHESIS: After resection of an @entity420 of the ampulla of Vater, certain clinical and pathologic characteristics influence long-term survival. DESIGN: Retrospective case series. SETTING: Major academic medical and pancreatic surgical center. @entity1 : Fifty-five consecutive @entity1 who underwent Whipple resection for @entity420 from 1988 through 2001. INTERVENTIONS: Pylorus-preserving Whipple resection in 32 @entity1 and standard Whipple resection in 23 @entity1 . MAIN OUTCOME MEASURES: Postoperative survival. A multivariate Cox proportional hazards model was used to determine the effects of various factors on long-term survival after resection. RESULTS: There were no operative deaths, and all @entity1 left the hospital. After a mean follow-up of 46.9 months, the overall 5-year Kaplan-Meier survival estimate was 67.7%. The median survival of the entire group has not yet been reached. Five-year postoperative survival estimates for node-negative (n = 32) and node-positive @entity1 (n = 23) were 76.5% and 53.4%, respectively (P =.26). @entity1 whose @entity5 demonstrated perineural invasion (n = 12) had a 5-year survival estimate of 29.2% vs 78.8% for those whose did not (P<.001). On multivariate analysis, the absence of perineural invasion (P<.001) was an independent predictor of significantly improved postoperative survival. CONCLUSIONS: Compared with previous reports from our own and other centers, this series demonstrates improved postoperative survival by 10% to 20% in @entity1 undergoing Whipple resection for @entity420 of the ampulla of Vater. The reasons for this improved outcome are unclear, and the effect of adjuvant treatment cannot be determined from this analysis. The major factor associated with prolonged survival was the absence of perineural invasion in the resected @entity5 specimen.

Improved survival for XXXX of the ampulla of Vater: fifty-five consecutive resections.

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients', 'PATIENTS'] @entity420 :: ('MESH:D000230', 'Disease') :: ['ampullary adenocarcinoma', 'adenocarcinoma'] @entity5 :: ('MESH:D009369', 'Disease') :: ['tumor', 'tumors']
@entity420 :: (MESH:D000230,Disease) :: ['adenocarcinoma']
