Comparative evaluation of pancreatic ductal and ampullary adenocarcinomas in terms of prognostic clinicopathologic features: A retrospective single- center experience in a tertiary hospital

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Abstract Introduction: Pancreatic ductal (PDACs), and ampullary (AACs) adenocarcinomas have different clinical and pathological prognostic features. The aim of our study is to comparatively evaluate the characteristic clinicopathologic features, prognostic factors and overall survival of resectable PDACs and AACs. Methods: We retrospectively compared a total of 120 patients with resectable adenocarcinomas stemming from main pancreatic duct, ampulla of Vater, and both regions in terms of prognostic clinicopathologic features and mean survival rates. Results: Adenocarcinomas (AC) originating from pancreatic ducts (n: 75) ,ampulla of Vater (n:19), and both of these anatomical (n:26) regions were pancreatobiliary (PB) (93.3%), intestinal (5.1%), and mixed ( 1.6%) histologic type tumors. There was no statistically significant difference between the tumor groups in terms of lymphovascular invasion (LVI) (p = 0.225), but perineural invasion (PNI) was seen at a statistically significantly lower rate in cases with AAC (p = 0.002). Lymph node involvement was seen more frequently in PDACs. A statistically significant intergroup difference was found when Pearson's chi-square test was used (p = 0.065). The median survival time was longer in AAC and stage I cases compared to those with PDAC and stage II-IV disease. Conclucion: In our study, tumor stage, perineural invasion and lymph node involvement were evaluated as important prognostic parameters in pancreatic and ampullary adenocarcinomas. A statistically significant difference was not detected between tumor groups regarding mean survival rates. Adenocarcinomas originating from the pancreatic head outside the ampullary region and also from the ampulla had independently poor prognostic factors closely comparable to PDACs.

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