{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T10:29:39Z","timestamp":1789122579628,"version":"build-2803163510"},"reference-count":45,"publisher":"Wiley","license":[{"start":{"date-parts":[[2014,3,2]],"date-time":"2014-03-02T00:00:00Z","timestamp":1393718400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/3.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["HPB Surgery"],"published-print":{"date-parts":[[2014,3,2]]},"abstract":"\n Introduction<\/jats:italic>\n . Although ampullary carcinoma has the best prognosis among all periampullary carcinomas, its long-term survival remains low. Prognostic factors are only available for a period of 10 years after pancreaticoduodenectomy. The aim of this retrospective study was to identify factors that influence the long-term patient survival over a 15-year observation period.\n Methods<\/jats:italic>\n . From 1992 to 2007, 143 patients with ampullary carcinoma underwent pancreatic resection. 86 patients underwent pylorus-preserving pancreaticoduodenectomy (60%) and 57 patients underwent standard Kausch-Whipple pancreaticoduodenectomy (40%).\n Results<\/jats:italic>\n . The overall 1-, 5-, 10-, and 15-year survival rates were 79%, 40%, 24%, and 10%, respectively. Within a mean observation period of 30 (0\u2013205) months, 100 (69%) patients died. Survival analysis showed that positive lymph node involvement\n \n \n \n \n P<\/mml:mi>\n =<\/mml:mo>\n 0.001<\/mml:mn>\n <\/mml:mrow>\n <\/mml:mfenced>\n <\/mml:mrow>\n <\/mml:math>\n , lymphatic vessel invasion\n \n \n \n \n P<\/mml:mi>\n =<\/mml:mo>\n 0.0001<\/mml:mn>\n <\/mml:mrow>\n <\/mml:mfenced>\n <\/mml:mrow>\n <\/mml:math>\n , intraoperative administration of packed red blood cells\n \n \n \n \n P<\/mml:mi>\n =<\/mml:mo>\n 0.03<\/mml:mn>\n <\/mml:mrow>\n <\/mml:mfenced>\n <\/mml:mrow>\n <\/mml:math>\n , an elevated CA 19-9\n \n \n \n \n P<\/mml:mi>\n =<\/mml:mo>\n 0.03<\/mml:mn>\n <\/mml:mrow>\n <\/mml:mfenced>\n <\/mml:mrow>\n <\/mml:math>\n , jaundice\n \n \n \n \n P<\/mml:mi>\n =<\/mml:mo>\n 0.04<\/mml:mn>\n <\/mml:mrow>\n <\/mml:mfenced>\n <\/mml:mrow>\n <\/mml:math>\n , and an impaired patient condition\n \n \n \n \n P<\/mml:mi>\n =<\/mml:mo>\n 0.01<\/mml:mn>\n <\/mml:mrow>\n <\/mml:mfenced>\n <\/mml:mrow>\n <\/mml:math>\n are strong negative predictors for a reduced patient survival.\n Conclusions<\/jats:italic>\n . Patients with ampullary carcinoma have distinctly better long-term survival than patients with pancreatic adenocarcinoma. Long-term survival depends strongly on lymphatic nodal and vessel involvement. Moreover, a preoperative elevated CA 19-9 proved to be a significant prognostic factor. Adjuvant therapy may be essential in patients with this risk constellation.\n <\/jats:p>","DOI":"10.1155\/2014\/970234","type":"journal-article","created":{"date-parts":[[2014,3,3]],"date-time":"2014-03-03T03:03:27Z","timestamp":1393815807000},"page":"1-8","source":"Crossref","is-referenced-by-count":56,"title":["Prognostic Factors for Long-Term Survival in Patients with Ampullary Carcinoma: The Results of a 15-Year Observation Period after Pancreaticoduodenectomy"],"prefix":"10.1155","volume":"2014","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8940-6001","authenticated-orcid":true,"given":"Fritz","family":"Klein","sequence":"first","affiliation":[{"name":"Department of General, Visceral, and Transplantation Surgery, Charit\u00e9 Campus Virchow Universit\u00e4tsmedizin Berlin, 13353 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dietmar","family":"Jacob","sequence":"additional","affiliation":[{"name":"Department of General and Visceral Surgery, 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Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Krannich","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Coordination Center for Clinical Trials, Charit\u00e9 Universit\u00e4tsmedizin Berlin, 13353 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Andreou","sequence":"additional","affiliation":[{"name":"Department of General, Visceral, and Transplantation Surgery, Charit\u00e9 Campus Virchow Universit\u00e4tsmedizin Berlin, 13353 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Safak","family":"G\u00fcl","sequence":"additional","affiliation":[{"name":"Department of General, Visceral, and Transplantation Surgery, Charit\u00e9 Campus Virchow Universit\u00e4tsmedizin Berlin, 13353 Berlin, 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