Surgical treatment of periampullary cancer--review of 766 surgical experiences of 8 hospitals.

S. M. Kim, Seon Hahn Kim, S. Y. Choi, Y. C. Kim

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Abstract

The incidence of periampullary cancer has been steadily rising in Korea. In the present study, we have reviewed 766 cases of surgically treated periampullary cancers, including 122 cases of our own, which were published in the Korean literature from 1984 to 1992. The 6th decade was the most prevalent age group, occupying 38% of the patients. The ratio of male of female was 1.7 to 1. Approximately 60% of lesion located at the head of the pancreas. Computed tomography which had 85% sensitivity was the most commonly employed modality for a diagnosis. The diagnostic sensitivity of percutaneous transhepatic cholangiography was 72%, of endoscopic retrograde cholangiopancreatography was 71%, and of ultrasonography was 54% in order of frequency. Tumor markers such as CA-19, CEA, and CA-125 were also studied in pancreatic cancer. The combinations of these markers recorded a higher positivity than using solely. The resection rate for lesions at the head of the pancreas was 21%, and that of distal common bile duct, ampulla of vater, and duodenum were 37%, 85%, and 50%, respectively. The morbidity and mortality rates after pancreatoduodenectomy were 44% and 12%, respectively. TNM staging revealed 66% of patients were in stage III, 26% in stage I, and 8% in stage II. The actual 5-year survival rates for cancer of the head of the pancreas was 11%, and that of duodenal cancer, distal choledochal cancer, and ampullary cancer were 21%, 18%, and 15%, respectively. In nonresected group, none survived over 18 months after treatment. Relatively high portion of lymph node metastatic patients may explain the poor survival observed in our series.

Original languageEnglish
Pages (from-to)297-303
Number of pages7
JournalJournal of Korean Medical Science
Volume7
Issue number4
Publication statusPublished - 1992 Dec 1

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Pancreatic Neoplasms
Pancreas
Neoplasms
Duodenal Neoplasms
Ampulla of Vater
Pancreaticoduodenectomy
Cholangiography
Neoplasm Staging
Endoscopic Retrograde Cholangiopancreatography
Common Bile Duct
Therapeutics
Korea
Tumor Biomarkers
Head and Neck Neoplasms
Duodenum
Ultrasonography
Survival Rate
Age Groups
Lymph Nodes
Tomography

ASJC Scopus subject areas

  • Medicine(all)

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Surgical treatment of periampullary cancer--review of 766 surgical experiences of 8 hospitals. / Kim, S. M.; Kim, Seon Hahn; Choi, S. Y.; Kim, Y. C.

In: Journal of Korean Medical Science, Vol. 7, No. 4, 01.12.1992, p. 297-303.

Research output: Contribution to journalArticle

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abstract = "The incidence of periampullary cancer has been steadily rising in Korea. In the present study, we have reviewed 766 cases of surgically treated periampullary cancers, including 122 cases of our own, which were published in the Korean literature from 1984 to 1992. The 6th decade was the most prevalent age group, occupying 38{\%} of the patients. The ratio of male of female was 1.7 to 1. Approximately 60{\%} of lesion located at the head of the pancreas. Computed tomography which had 85{\%} sensitivity was the most commonly employed modality for a diagnosis. The diagnostic sensitivity of percutaneous transhepatic cholangiography was 72{\%}, of endoscopic retrograde cholangiopancreatography was 71{\%}, and of ultrasonography was 54{\%} in order of frequency. Tumor markers such as CA-19, CEA, and CA-125 were also studied in pancreatic cancer. The combinations of these markers recorded a higher positivity than using solely. The resection rate for lesions at the head of the pancreas was 21{\%}, and that of distal common bile duct, ampulla of vater, and duodenum were 37{\%}, 85{\%}, and 50{\%}, respectively. The morbidity and mortality rates after pancreatoduodenectomy were 44{\%} and 12{\%}, respectively. TNM staging revealed 66{\%} of patients were in stage III, 26{\%} in stage I, and 8{\%} in stage II. The actual 5-year survival rates for cancer of the head of the pancreas was 11{\%}, and that of duodenal cancer, distal choledochal cancer, and ampullary cancer were 21{\%}, 18{\%}, and 15{\%}, respectively. In nonresected group, none survived over 18 months after treatment. Relatively high portion of lymph node metastatic patients may explain the poor survival observed in our series.",
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