{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T05:58:44Z","timestamp":1789192724450,"version":"build-2803163510"},"reference-count":24,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2004,10,29]],"date-time":"2004-10-29T00:00:00Z","timestamp":1099008000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/501100006390","name":"Sicpa, Foundation, Prilly, Switzerland and Fondation du 450\u00e8me Anniversaire de l'Universit\u00e9 de Lausanne, Lausanne, Switzerland","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100006390","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2004,11,17]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Ampullary tumours are relatively rare, and few large single-centre reports provide information on their treatment and outcome. The aim of this study was to analyse outcome and determine predictors of survival for patients with ampullary tumours treated in a specialist centre.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Over an 11-year period, 561 patients were treated for periampullary tumours, 88 of whom had a histologically proven ampullary neoplasm. Prospectively gathered data were analysed to assess predictors of survival.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The overall resection rate was 92 per cent; there were no postoperative deaths. Median survival was 45\u00b78 months for patients with resectable tumours and 8\u00b70 months for those with irresectable disease (P &amp;lt; 0\u00b7001). On univariate analysis, age less than 70 years (P = 0\u00b7015) and a bilirubin level of 75 \u00b5mol\/l or less (P = 0\u00b7012) favoured long-term survival. Among 70 patients who underwent cancer resection, factors associated with significantly worse long-term survival on univariate analysis included poorly differentiated tumour (P &amp;lt; 0\u00b7001), positive nodes (P &amp;lt; 0\u00b7001), perineural invasion (P = 0\u00b7001) and invasion of the pancreas (P = 0\u00b7018). Multivariate analysis identified positive nodes and bilirubin concentration as independent predictors of survival.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>An aggressive surgical approach to ampullary tumours is justified by the low proportion of benign lesions, the absence of postoperative mortality and improved long-term survival.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1002\/bjs.4787","type":"journal-article","created":{"date-parts":[[2004,11,17]],"date-time":"2004-11-17T13:17:24Z","timestamp":1100697444000},"page":"1600-1607","source":"Crossref","is-referenced-by-count":46,"title":["Presentation, treatment and outcome in patients with ampullary tumours"],"prefix":"10.1093","volume":"91","author":[{"given":"V","family":"Bettschart","sequence":"first","affiliation":[{"name":"Department of Surgery, Sherbrooke University, Sherbrooke, Quebec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M Q","family":"Rahman","sequence":"additional","affiliation":[{"name":"Department of Clinical and Surgical Sciences (Surgery), Royal Infirmary of Edinburgh, Edinburgh, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F J F","family":"Engelken","sequence":"additional","affiliation":[{"name":"Department of Clinical and Surgical Sciences (Surgery), Royal Infirmary of Edinburgh, Edinburgh, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K K","family":"Madhavan","sequence":"additional","affiliation":[{"name":"Department of Clinical and Surgical Sciences (Surgery), Royal Infirmary of Edinburgh, Edinburgh, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R W","family":"Parks","sequence":"additional","affiliation":[{"name":"Department of Clinical and Surgical Sciences (Surgery), Royal Infirmary of Edinburgh, Edinburgh, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"O J","family":"Garden","sequence":"additional","affiliation":[{"name":"Department of Clinical and Surgical Sciences (Surgery), Royal Infirmary of Edinburgh, Edinburgh, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2004,10,29]]},"reference":[{"key":"2021070907205404000_bib1","doi-asserted-by":"crossref","first-page":"957","DOI":"10.1002\/bjs.1800741025","article-title":"Treatment and outcome in 52 consecutive cases of ampullary carcinoma","volume":"74","author":"Neoptolemos","year":"1987","journal-title":"Br J Surg"},{"key":"2021070907205404000_bib2","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1097\/00000658-199502000-00005","article-title":"Carcinoma of the pancreatic head and periampullary region. 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