Results of surgical treatment of patients with papilla vateri cancer

Goal. To improve results of surgical treatment of patients with Papilla Vateri cancer. Materials and methods. 253 patients with Papilla Vateri cancer were identified between years 1976 and 2017 at the Surgical Department of Pancreas and Liver Cancer of National Medical Research Centre of Oncology n.a. N. N. Blokhin in Moscow, Russia. Results. Multivariate analysis with Cox regression model revealed that 7 factors were independently associated to a longer overall survival, which included intestinal pathomorphological type of the tumor, tumor size ≤ 2 cm, no lymph node involvement, time of operation ≤ 270 min., no pancreatic stump complications, pancreaticogastrostomy vs. pancreaticojejunostomy, method of treatment (combined treatment vs. surgery alone). The increase of amount of prognostic factors leads to a shorter overall survival. The combined treatment of patients with pancreato-biliary type of Papilla Vateri cancer results in better survival comparing to surgery alone (3-year survival 65 ± 15 % vs. 49 ± 8 %, median 37 vs. 35 months respectively; p = 0.006), while patients with intestinal type of cancer showed no difference in these groups. Conclusions. Pancreato-biliary type of cancer is associated with poorer survival comparing to intestinal type. The combined treatment with adjuvant chemotherapy in patient with pancreato-biliary type of cancer improves overall survival.

major duodenal papilla, intestinal type, pancreato-biliary type, pathological type of tumor, gastropancreatoduodenal resection, combined treatment, adjuvant chemotherapy, survival, prognostic factors

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