Compared with adenocarcinoma of the head of the pancreas, carcinoma of the periampullary region (ampulla of Vater) carries a substantially better 5-year survival after resection. The main reason is:
- A Periampullary tumours are biologically less aggressive regardless of stage
- B Whipple's operation is technically easier for ampullary tumours, permitting wider margins
- C Early obstruction of the common bile duct leads to earlier presentation at a smaller, more curable stage ✓
- D Ampullary cancers rarely metastasize to lymph nodes
Correct answer: C. Early obstruction of the common bile duct leads to earlier presentation at a smaller, more curable stage
Explanation
Because the ampulla sits within the distal bile duct, even small tumours obstruct the duct early, producing jaundice long before invasion or spread, so they are diagnosed at lower T and N stages. Stage-for-stage, survival is similar to pancreatic cancer. Lymph node metastasis certainly occurs, and the technical ease of resection does not explain the survival gap.
Reference: Sabiston Textbook of Surgery, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.