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J Hepatobiliary Pancreat Sci. 2017 Aug;24(8):475-484. doi: 10.1002/jhbp.486. Epub 2017 Aug 4.

Proposed new staging system for ampulla of Vater cancer with greater discriminatory ability: multinational study from eastern and western centers.

Author information

1
Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
2
Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
3
Department of Mathematics and Statistics, Sejong University College of Natural Sciences, Seoul, Korea.
4
Department of Statistics, Seoul National University College of Natural Sciences, Seoul, Korea.

Abstract

BACKGROUND:

We built a multinational retrospective database of patients with ampulla of Vater cancer to develop a reliable new staging system.

METHOD:

This study included 841 patients with ampulla of Vater cancer after curative surgery at Seoul National University Hospital (n = 440) and Johns Hopkins University medical institutions (n = 401) between 1985 and 2013.

RESULTS:

The 5-year overall survival (OS) rates of patients staged according to the 7th American Joint Committee on Cancer staging system were 80.3%, 60.9%, 58.1%, 36.6%, 17.9%, and 25.0% for Stages IA (n = 140), IB (n = 194), IIA (n = 115), IIB (n = 348), III (n = 33), and IV (n = 4), respectively. Five-year OS rates were similar in patients with Stage IB (T2N0M0) and IIA (T3N0M0) tumors (P = 0.556), but differed significantly between other pairs of groups. The number of positive lymph nodes (PLN) enhanced prognosis when stratified as 0, 1-2 and ≥3 (P < 0.001). The revised staging system consisted of Stages I (T1, PLN 0), IIA (T2-T3, PLN 0), IIB (T1-T3, PLN 1-2), III (PLN ≥3 or any T4), and IV (any M1), with 5-year OS rates differing significantly in each pair of groups, including Stages I and IIA (P < 0.001).

CONCLUSION:

This new staging system has better discriminatory ability in stratifying 5-year OS rates based on a large multinational database.

KEYWORDS:

Ampulla of Vater; Cancer staging; Neoplasm staging

PMID:
28660632
DOI:
10.1002/jhbp.486
[Indexed for MEDLINE]

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