Published online Nov 27, 2022. doi: 10.4240/wjgs.v14.i11.1219
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
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.
The lymph node metastasis (LNM) patterns and the optimal range of lymph node dissection in DC-II and AC remain controversial.
The present study aimed to elucidate differences in clinicopathological characteristics, especially the patterns of LNM, between AC and DC-II.
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.
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.
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.
Lymph node dissection to N-He and N-Py may be omitted for AC, that is unlikely for DC-II.