Retrospective Cohort Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Nov 27, 2022; 14(11): 1219-1229
Published online Nov 27, 2022. doi: 10.4240/wjgs.v14.i11.1219
Comparison of clinicopathological characteristics between resected ampullary carcinoma and carcinoma of the second portion of the duodenum
Kohei Nishio, Kenjiro Kimura, Akihiro Murata, Go Ohira, Hiroji Shinkawa, Shintaro Kodai, Ryosuke Amano, Shogo Tanaka, Sadatoshi Shimizu, Shigekazu Takemura, Akishige Kanazawa, Shoji Kubo, Takeaki Ishizawa
Kohei Nishio, Kenjiro Kimura, Go Ohira, Hiroji Shinkawa, Ryosuke Amano, Shogo Tanaka, Shigekazu Takemura, Shoji Kubo, Takeaki Ishizawa, Department of Hepato-Biliary-Pancreatic Surgery, Osaka Metropolitan University, Osaka 5458585, Japan
Akihiro Murata, Shintaro Kodai, Sadatoshi Shimizu, Akishige Kanazawa, Department of Hepato-Biliary-Pancreatic Surgery, Osaka City General Hospital, Osaka 5340021, Japan
Author contributions: Nishio K designed the study and wrote the draft of the article. Kimura K and Kubo S contributed to interpretation of the data and the critical revision of the article content. All the other authors (Murata A, Ohira G, Shinkawa H, Kodai S, Amano R, Takemura S, Shimizu S, Kanazawa A and Ishizawa A) contributed to the data collection and interpretation and critically reviewed the article; All the authors have read and agreed to the article.
Institutional review board statement: This study was approved by the Ethics Committees of Osaka City University (approval No. 2020-198) and Osaka City General Hospital (approval No. 1910076) and was performed in compliance with the Declaration of Helsinki.
Informed consent statement: All patients provided informed consent for using their data in this study according to the institutional regulations of the study sites.
Conflict-of-interest statement: All authors declare that they have no competing interests related to the manuscript.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement – checklist of items, and the manuscript was prepared and revised according to the STROBE Statement – checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Kenjiro Kimura, Doctor, MD, PhD, Doctor, Department of Hepato-Biliary-Pancreatic Surgery, Osaka Metropolitan University, 1-4-3 Asahimachi, Abeno-ku, Osaka 5458585, Japan.
Received: July 22, 2022
Peer-review started: July 22, 2022
First decision: September 26, 2022
Revised: October 10, 2022
Accepted: October 19, 2022
Article in press: October 19, 2022
Published online: November 27, 2022
Research background

Few studies have compared the oncological and biological characteristics between ampullary carcinoma (AC) and cancer of the second portion of the duodenum (DC-II), although both tumors arise from anatomically close locations.

Research motivation

The lymph node metastasis (LNM) patterns and the optimal range of lymph node dissection in DC-II and AC remain controversial.

Research objectives

The present study aimed to elucidate differences in clinicopathological characteristics, especially the patterns of LNM, between AC and DC-II.

Research methods

This was a retrospective cohort study of 80 patients with AC and 27 patients with DC-II who underwent pancreaticoduodenectomy between January 1998 and December 2018 in two institutions. Clinicopathological factors, LNM patterns, and prognosis were compared between the two groups.

Research results

The rate of preoperative biliary drainage was significantly higher and the rates of digestive symptoms, ulcerative-type cancer, large tumor diameter, and advanced tumor stage were significantly lower in patients with AC than DC-II. There were no significant differences in prognosis, recurrence, and lymph node metastasis rates between the two groups, although hepatic and pyloric lymph node metastases were more frequent in DC-II than in AC.

Research conclusions

Although there were no significant differences in the prognosis and recurrence rates between the two groups, metastases to N-He and N-Py were more frequent in patients with DC-II than in those with AC.

Research perspectives

Lymph node dissection to N-He and N-Py may be omitted for AC, that is unlikely for DC-II.