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©The Author(s) 2024.
World J Gastroenterol. Oct 21, 2024; 30(39): 4281-4294
Published online Oct 21, 2024. doi: 10.3748/wjg.v30.i39.4281
Published online Oct 21, 2024. doi: 10.3748/wjg.v30.i39.4281
Table 1 Demographic data and clinical outcomes of ampulla of Vater cancer and duodenal papilla cancer, n (%)
| Variables | AVC (n = 145) | DPC (n = 211) | P value |
| Age, year | 59 (52-64) | 58 (52-64) | 0.78 |
| ≤ 60 | 88 (60.7) | 125 (59.2) | |
| > 60 | 57 (39.3) | 86 (40.8) | |
| Sex | 0.78 | ||
| Male | 75 (51.7) | 106 (50.2) | |
| Female | 70 (48.3) | 105 (49.8) | |
| BMI, kg/m2 | 0.50 | ||
| < 18.5 | 11 (8.1) | 24 (12.1) | |
| 18.5-24 | 96 (71.1) | 133 (67.2) | |
| ≥ 24 | 28 (20.8) | 41 (20.7) | |
| Diabetes | 0.74 | ||
| Yes | 9 (6.2) | 15 (7.1) | |
| No | 136 (93.8) | 196 (92.9) | |
| Neutrophil count, × 109/L | 4.17 ± 2.3 | 4.15 ± 2.3 | 0.9 |
| Lymphocyte count, × 109/L | 1.34 ± 0.4 | 1.36 ± 0.5 | 0.88 |
| Blood platelet count, × 109/L | 259.89 ± 97.7 | 251.42 ± 90.8 | 0.28 |
| Albumin, g/L | 35.83 ± 4.80 | 36.46 ± 4.5 | 0.35 |
| Tbil, μmol/L | 117.19 ± 112.9 | 88.57 ± 93.8 | 0.04a |
| ALT, U/L | 138.34 ± 136.5 | 128.97 ± 109.9 | 0.77 |
| AST, U/L | 112.73 ± 110.1 | 100.39 ± 84.7 | 0.93 |
| CA19-9, U/mL | 433.35 ± 1405.4 | 499.65 ± 1807.2 | 0.61 |
| NLR | 3.49 ± 2.42 | 3.59 ± 3.28 | 0.86 |
| PLR | 215.32 ± 116 | 205.33 ± 103.43 | 0.55 |
| PNI | 41.99 ± 7.1 | 42.67 ± 7.34 | 0.39 |
| ASA | 0.10 | ||
| I | 12 (8.3) | 26 (12.3) | |
| II | 101 (69.7) | 155 (73.5) | |
| III | 32 (22.1) | 30 (14.2) |
Table 2 Perioperative outcomes of ampulla of Vater cancer and duodenal papilla cancer, n (%)
| Variables | AVC (n = 145) | DPC (n = 211) | P value |
| Duration of surgery, min | 350 (290-420) | 324.5 (256.3-413) | 0.16 |
| Intraoperative blood loss, mL | 275 (100-400) | 275 (100-500) | 0.76 |
| Postoperative hospital stay, day | 22.32 ± 9.8 | 21.96 ± 9.5 | 0.72 |
| Surgical margin | 0.67 | ||
| Negative | 142 (97.9) | 209 (99.1) | |
| Positive | 3 (2.1) | 2 (0.9) | |
| TNM stage | 0.58 | ||
| I | 68 (62.4) | 126 (68.1) | |
| II | 31 (28.4) | 46 (24.9) | |
| III | 10 (9.2) | 13 (7.0) | |
| Tumor size, cm | 1.7 ± 1.5 | 1.9 ± 1.7 | 0.59 |
| Number of positive lymph nodes | 0.83 | ||
| ≤ 1 | 118 (84.3) | 166 (83.4) | |
| ≥ 2 | 22 (15.7) | 33 (16.6) | |
| Delayed gastric emptying | 0.35 | ||
| Yes | 91 (62.8) | 122 (57.8) | |
| No | 54 (37.2) | 89 (42.2) | |
| Pancreas fistula | 0.74 | ||
| Yes | 43 (29.7) | 66 (31.3) | |
| No | 102 (70.3) | 145 (68.7) | |
| Postoperative hemorrhage | 0.67 | ||
| Yes | 8 (5.5) | 14 (6.6) | |
| No | 137 (94.5) | 197 (93.4) | |
| Postoperative infection | 0.87 | ||
| Yes | 5 (3.4) | 8 (3.8) | |
| No | 140 (96.6) | 203 (96.2) | |
| Adjuvant therapy | 0.72 | ||
| Yes | 28 (19.3) | 44 (20.9) | |
| No | 117 (80.7) | 167 (79.1) | |
| Overall survival, month | 44.3 ± 35.9 | 58.9 ± 38.7 | < 0.01a |
Table 3 Univariate and multivariate Cox regression analysis of ampulla of Vater cancer
| Characteristics | Univariate | Multivariate | ||
| HR (95%CI) | P value | HR (95%CI) | P value | |
| Sex (male/female) | 1.079 (0.600-1.938) | 0.800 | ||
| Age (≤ 60/> 60), year | 0.877 (0.485-1.586) | 0.664 | ||
| BMI, kg/m2 | ||||
| < 18.5 | Reference | |||
| 18.5-24 | 1.256 (0.298-5.298) | 0.756 | ||
| > 24 | 1.876 (0.414-8.494) | 0.414 | ||
| Diabetes (yes/no) | 1.048 (0.253-4.348) | 0.949 | ||
| Neutrophil count (≤ 5.39/> 5.39), × 109/L | 2.434 (0.961-6.168) | 0.061 | ||
| Lymphocyte count (≤ 1.21/> 1.21), × 109/L | 1.812 (1.006-3.262) | 0.048a | 1.849 (0.969-3.529) | 0.062 |
| Blood platelet count (≤ 165/> 165), × 109/L | 2.083 (1.074-4.039) | 0.030a | 1.791 (0.893-3.591) | 0.101 |
| Albumin (≤ 38.45/> 38.45), g/L | 1.840 (1.015-3.336) | 0.045a | 2.387 (1.247-4.569) | < 0.01a |
| ALT (≤ 283/> 283), U/L | 0.369 (0.114-1.192) | 0.096 | ||
| AST (≤ 277/> 277), U/L | 0.437 (0.106-1.803) | 0.252 | ||
| Tbil (≤ 28.4/> 28.4), μmol/L | 0.440 (0.205-0.945) | 0.035a | 0.343 (0.143-0.825) | 0.017a |
| NLR (≤ 5.90/> 5.90) | 0.181 (0.025-1.315) | 0.091 | ||
| PLR (≤ 186.6/> 186.6) | 0.737 (0.408-1.332) | 0.312 | ||
| PNI (≤ 44.6/> 44.6) | 0.664 (0.363-1.214) | 0.183 | ||
| CA19-9 (≤ 37.54/> 37.54), U/mL | 1.258 (0.690-2.291) | 0.454 | ||
| ASA | ||||
| I | Reference | |||
| II | 0.536 (0.223-1.288) | 0.163 | ||
| III | 0.633 (0.225-1.786) | 0.388 | ||
| T stage | ||||
| T1 | Reference | |||
| T2 | 1.641 (0.811-3.321) | 0.168 | ||
| T3 | 1.354 (0.392-4.679) | 0.632 | ||
| N stage | ||||
| N0 | Reference | |||
| N1 | 1.389 (0.642-3.005) | 0.404 | ||
| N2 | 1.524 (0.355-6.529) | 0.571 | ||
| TNM stage | ||||
| I | Reference | |||
| II | 1.142 (0.516-2.526) | 0.743 | ||
| III | 2.413 (0.959-6.072) | 0.061 | ||
| Duration of surgery (≤ 368/> 368), min | 0.853 (0.471-1.544) | 0.599 | ||
| Intraoperative blood loss (280 ≤ /> 280), mL | 0.895 (0.464-1.726) | 0.741 | ||
| Tumor size (≤ 1.99/> 1.99), cm | 0.475 (0.210-1.072) | 0.073 | ||
| Number of positive lymph nodes (≤ 1/≥ 2) | 0.407 (0.208-0.796) | < 0.01a | 0.375 (0.189-0.745) | < 0.01a |
| Adjuvant therapy (yes/no) | 0.988 (0.475-2.053) | 0.974 | ||
Table 4 Univariate and multivariate Cox regression analysis of duodenal papilla cancer
| Characteristics | Univariate | Multivariate | ||
| HR (95%CI) | P value | HR (95%CI) | P value | |
| Sex (male/female) | 1.226 (0.698-2.154) | 0.478 | ||
| Age (≤ 60/> 60), year | 0.461 (0.262-0.811) | 0.007a | 0.372 (0.189-0.733) | 0.004a |
| BMI, kg/m2 | ||||
| < 18.5 | Reference | |||
| 18.5-24 | 0.693 (0.306-1.569) | 0.380 | ||
| > 24 | 0.375 (0.126-1.120) | 0.079 | ||
| Diabetes (yes/no) | 3.832 (0.529-27.767) | 0.184 | ||
| Neutrophil count (≤ 2.815/> 2.815), × 109/L | 1.751 (0.991-3.096) | 0.054 | ||
| Lymphocyte count (≤ 1.395/> 1.395), × 109/L | 2.910 (1.486-5.698) | 0.002a | 2.446 (0.932-6.418) | 0.069 |
| Blood platelet count (≤ 196.5/> 196.5), × 109/L | 1.556 (0.870-2.782) | 0.136 | ||
| Preoperative albumin (≤ 32.5/> 32.5), g/L | 2.579 (1.431-4.647) | 0.002a | 2.266 (0.666-7.711) | 0.191 |
| ALT (≤ 114.5/> 114.5), U/L | 0.633 (0.361-1.109) | 0.110 | ||
| AST (≤ 51.5 /> 51.5), U/L | 0.575 (0.287-1.153) | 0.119 | ||
| Tbil (≤ 27.25/> 27.25), μmol/L | 0.354 (0.166-0.755) | 0.007a | 0.634 (0.248-1.619) | 0.341 |
| NLR (≤ 3.21/> 3.21) | 0.663 (0.376-1.171) | 0.157 | ||
| PLR (≤ 184.92/> 184.92) | 0.539 (0.306-0.949) | 0.032a | 0.734 (0.334-1.614) | 0.442 |
| PNI (≤ 36.98/> 36.98) | 2.333 (1.216-4.476) | 0.011a | 0.315 (0.072-1.379) | 0.125 |
| CA19-9 (≤ 143.9/> 143.9), U/mL | 0.414 (0.235-0.731) | 0.002a | 0.808 (0.389-1.678) | 0.567 |
| ASA | ||||
| I | Reference | |||
| II | 0.540 (0.220-1.290) | 0.160 | ||
| III | 0.630 (0.230-1.790) | 0.380 | ||
| T stage | ||||
| T1 | Reference | |||
| T2 | 1.740 (0.949-3.189) | 0.073 | ||
| T3 | 2.601 (0.610-11.088) | 0.196 | ||
| N stage | ||||
| N0 | Reference | |||
| N1 | 2.154 (1.128-4.113) | 0.020a | 0.800 (0.201-3.189) | 0.752 |
| N2 | 3.123 (0.942-10.354) | 0.063 | 0.365 (0.038-3.554) | 0.386 |
| TNM stage | ||||
| I | - | Reference | ||
| II | 1.948 (1.001-3.790) | 0.050 | 1.973 (0.598-6.516) | 0.265 |
| III | 4.344 (1.856-10.165) | 0.001a | 3.247 (0.402-26.228) | 0.269 |
| Duration of surgery, min (≤ 351/> 351) | 1.791 (0.982-3.266) | 0.058 | ||
| Intraoperative blood loss, mL (305 ≤/> 305) | 0.802 (0.454-1.414) | 0.445 | ||
| Tumor size (≤ 2.35/> 2.35), cm | 0.463 (0.263-0.816) | 0.008a | 0.436 (0.213-0.893) | 0.023a |
| Number of positive lymph nodes (≤ 1/≥ 2) | 0.446 (0.230-0.865) | 0.017a | 0.328 (0.141-0.767) | 0.010a |
| Adjuvant therapy (yes/no) | 0.253 (0.079-0.815) | 0.021a | 0.233 (0.068-0.797) | 0.020a |
- Citation: Zhang JZ, Zhang ZW, Guo XY, Zhu DS, Huang XR, Cai M, Guo T, Yu YH. Comparison of clinical characteristics and prognostic factors in two site-specific categories of ampullary cancer. World J Gastroenterol 2024; 30(39): 4281-4294
- URL: https://www.wjgnet.com/1007-9327/full/v30/i39/4281.htm
- DOI: https://dx.doi.org/10.3748/wjg.v30.i39.4281