ArticleTranslational cancer research2020
Choice of surgical procedures for patients with stage T1 carcinoma of the papilla of Vater: a retrospective study.
Article in Translational cancer research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed, 1 citations in OpenAlex.
- Endoscopic Papillectomy for Ampullary Tumors in Older Patients: Balancing Oncologic Benefit and Geriatric Risk.Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society · 2026Review
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5 authors at 2 institutions in 1 country.
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Abstract
backgroundGiven the high incidence of complications after pancreaticoduodenectomy (PD), local resection is being applied to cure stage T1 carcinoma of the papilla of Vater (CPV). In the present study, risk factors related to nodal involvement and prognosis were evaluated so as to enable the choice of optimal surgical procedure for patients with stage T1 CPV.
methodsA retrospective study of 94 consecutive patients with CPV who underwent PD in our center from 2013 to 2018 was conducted.
resultsA total of 44 patients (46.8%; 44 of 94) had lymph node metastasis. T1 tumors were subdivided into layer I (the mucosa) and layer II (the submucosa) based on anatomical stratification, and lymph node metastasis did not occur in patients with layer I invasion. The nodal metastasis rate was up to 25% (6 of 24) in patients with layer II invasion. The gross appearance, depth of duodenal invasion, pT stage and perineural invasion were risk factors related to nodal involvement. Only the depth of duodenal invasion remained a significant independent factor (P=0.003). Multivariate Cox analysis indicated that depth of duodenal invasion (P=0.001), nodal involvement (P<0.001), and venous invasion (P<0.001) were independent prognostic factors. The depth of duodenal invasion is the only independent risk factor related to nodal involvement and prognosis.
conclusionsThe optimal surgical option should be PD with radical lymphadenectomy for patients with stage T1 CPV; only patients with duodenal invasion limited to the mucosa are suitable for local resection. A modified T category needs to be proposed based on the detailed depth of duodenal invasion.
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