Compared with carcinoma of the body and tail of the pancreas of similar stage, ampullary carcinoma carries a substantially better prognosis. The principal reason is:

• A Ampullary tumours are less often resected
• B Chemotherapy is more effective against ampullary histology
• C Ampullary tumours rarely metastasise to lymph nodes
• D Early biliary obstruction leads to earlier diagnosis at a smaller size ✓

Explanation

Because the ampulla sits within the distal bile duct, even small tumours obstruct the duct and produce painless jaundice early, so ampullary cancers are typically diagnosed at 2 cm or less, when cure rates after pancreaticoduodenectomy approach 40 percent or higher. Body and tail tumours present late without such a warning sign. Ampullary tumours still spread to peripancreatic nodes frequently, and their survival advantage rests mainly on stage at diagnosis.

Reference: Sabiston Textbook of Surgery, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.