{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T16:54:27Z","timestamp":1772988867208,"version":"3.50.1"},"reference-count":18,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,6,30]],"date-time":"2025-06-30T00:00:00Z","timestamp":1751241600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,6,30]],"date-time":"2025-06-30T00:00:00Z","timestamp":1751241600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Ampullary adenocarcinoma, classified by site\u2010specific and histologic subtypes, lacks comprehensive studies. This study aims to update the clinicopathological features of ampullary adenocarcinoma, focusing on these classifications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective analysis of primary malignant tumors at the papilla of Vater (2002\u20132022) in our facility. Invasive adenocarcinoma cases were subclassified into intra\u2010ampullary papillary\u2010tubular neoplasm (IAPN)\u2010associated carcinoma, ampullary\u2010ductal carcinoma, periampullary\u2010ductal carcinoma, and ampullary\u2010not otherwise specified (NOS) carcinoma. Additionally, a cell\u2010lineage classification divided cases into intestinal type and gastric\/pancreatobiliary type.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 63 cases of primary malignant tumors, 54 were invasive adenocarcinoma: 6 (Periampullary\u2010duodenal carcinoma), 14 (IAPN\u2010associated carcinoma), 21 (Ampullary\u2010ductal carcinoma), and 13 (Ampullary\u2010NOS carcinoma). IAPN\u2010associated and Periampullary\u2010duodenal carcinomas had lower pT stages and less lymph node metastasis compared to Ampullary\u2010ductal carcinoma. Lymphovascular invasion and perineural invasion were more prevalent in Ampullary\u2010ductal carcinoma. Tumor size was larger in Periampullary\u2010duodenal carcinoma, while well\u2010differentiated tumors were more common in IAPN\u2010associated and Periampullary\u2010duodenal carcinomas. Intestinal type was more frequent in IAPN\u2010associated and Periampullary\u2010duodenal carcinomas. Gastric\/pancreatobiliary types had higher pT stages, more lymph node metastasis, and greater lymphovascular invasion. Although the intestinal type showed a trend toward better prognosis, the differences were not statistically significant.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study highlights the distinct clinicopathological features of ampullary adenocarcinoma based on site\u2010specific and cell\u2010lineage classifications. Future large\u2010scale studies are needed for better patient stratification and management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ans.70240","type":"journal-article","created":{"date-parts":[[2025,6,30]],"date-time":"2025-06-30T08:41:02Z","timestamp":1751272862000},"page":"1764-1773","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Clinicopathological Exploration of Ampullary Adenocarcinoma"],"prefix":"10.1111","volume":"95","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6705-5730","authenticated-orcid":false,"given":"Miho","family":"Akabane","sequence":"first","affiliation":[{"name":"Hepatobiliary\u2010Pancreatic Surgery Division, Department of Gastroenterological Surgery Toranomon Hospital  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ayako","family":"Kume","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Pathology Toranomon Hospital  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masaji","family":"Hashimoto","sequence":"additional","affiliation":[{"name":"Hepatobiliary\u2010Pancreatic Surgery Division, Department of Gastroenterological Surgery Toranomon Hospital  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yutaka","family":"Takazawa","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Pathology Toranomon Hospital  Tokyo 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