Hide metadata

dc.contributor.authorWestgaard, Arne
dc.contributor.authorTafjord, Svetlana
dc.contributor.authorFarstad, Inger N
dc.contributor.authorCvancarova, Milada
dc.contributor.authorEide, Tor J
dc.contributor.authorMathisen, Oystein
dc.contributor.authorPetter F Clausen, Ole
dc.contributor.authorGladhaug, Ivar P
dc.date.accessioned2015-10-09T02:10:44Z
dc.date.available2015-10-09T02:10:44Z
dc.date.issued2008
dc.identifier.citationBMC Cancer. 2008 Jun 11;8(1):170
dc.identifier.urihttp://hdl.handle.net/10852/46674
dc.description.abstractBackground Resectable adenocarcinomas in the pancreatic head, by definition "periampullary", originate from ampullary, duodenal, biliary, or ductal pancreatic epithelium. Typically, periampullary adenocarcinomas have either intestinal or pancreatobiliary type of differentiation, and the type of differentiation might be prognostically more important than the anatomic site of origin. The aim of the study was to determine whether the histologic type of differentiation is an independent prognostic factor in periampullary adenocarcinoma, and whether tumour origin predicts the prognosis in pancreatobiliary type carcinomas independently of resection margin involvement, tumour size, nodal involvement, perineural and vascular infiltration, and degree of differentiation. Methods Histopathologic variables in 114 consecutively resected periampullary adenocarcinomas of pancreatobiliary (n = 67) and intestinal (n = 47) type differentiation were evaluated using a standardized, systematic protocol for evaluation of the resected specimen (study group). Histologic type of differentiation and tumour origin were compared as predictors of survival, and the results were validated by comparison with a historical control group consisting of 99 consecutive pancreaticoduodenectomies performed before standardization of histopathologic evaluation. Associations between histopathologic variables were evaluated by Chi-square and Mann-Whitney tests. Survival was estimated by the Kaplan-Meier method, comparing curves using log-rank test, and by univariate and multivariable Cox regression analysis. Results Both in the study group (n = 114) and in the historical control group (n = 99), the histologic type of differentiation independently predicted survival, while tumour origin predicted survival only in univariate analysis. Independent adverse predictors of survival in the study group were pancreatobiliary type differentiation (p < 0.001; HR 3.1; CI 1.8–5.1), regional lymph node involvement (p < 0.001; HR 2.5; CI 1.5–4.4), vessel involvement (p = 0.012; HR 1.9; CI 1.2–3.1), and increasing tumour diameter (measured in cm, p = 0.011; HR 1.3; CI 1.1–1.5). For pancreatobiliary differentiated adenocarcinomas (n = 67), lymph node status, vessel involvement, and tumour diameter remained independent prognostic factors, while tumour origin did not independently predict the prognosis due to significant association with tumour size (p < 0.001) and lymph node involvement (p = 0.004). Conclusion Pancreatobiliary versus intestinal type of differentiation independently predicts poor prognosis after pancreaticoduodenectomy for periampullary adenocarcinoma. Lymph node involvement, vessel infiltration, and increasing tumour diameter are adverse predictors of survival in tumours with pancreatobiliary differentiation.
dc.language.isoeng
dc.rightsWestgaard et al.
dc.rightsAttribution 2.0 Generic
dc.rights.urihttp://creativecommons.org/licenses/by/2.0/
dc.titlePancreatobiliary versus intestinal histologic type of differentiation is an independent prognostic factor in resected periampullary adenocarcinoma
dc.typeJournal article
dc.date.updated2015-10-09T02:10:44Z
dc.creator.authorWestgaard, Arne
dc.creator.authorTafjord, Svetlana
dc.creator.authorFarstad, Inger N
dc.creator.authorCvancarova, Milada
dc.creator.authorEide, Tor J
dc.creator.authorMathisen, Oystein
dc.creator.authorPetter F Clausen, Ole
dc.creator.authorGladhaug, Ivar P
dc.identifier.doihttp://dx.doi.org/10.1186/1471-2407-8-170
dc.identifier.urnURN:NBN:no-50855
dc.type.documentTidsskriftartikkel
dc.type.peerreviewedPeer reviewed
dc.identifier.fulltextFulltext https://www.duo.uio.no/bitstream/handle/10852/46674/1/12885_2007_Article_1108.pdf
dc.type.versionPublishedVersion
cristin.articleid170


Files in this item

Appears in the following Collection

Hide metadata

Attribution 2.0 Generic
This item's license is: Attribution 2.0 Generic