Compared with carcinoma of the head of the pancreas, carcinoma of the ampulla of Vater has a substantially better prognosis. The main reason is:
- A It causes early jaundice, leading to diagnosis at a smaller tumor size ✓
- B It is less likely to metastasize to lymph nodes
- C It is chemosensitive to gemcitabine-based therapy
- D It arises from endocrine cells rather than epithelium
Correct answer: A. It causes early jaundice, leading to diagnosis at a smaller tumor size
Explanation
Because the ampulla sits within the distal bile duct, even small tumors obstruct drainage early and produce jaundice while the lesion is still resectable, giving 5-year survival around 40 percent versus under 10 percent for pancreatic ductal adenocarcinoma. Ampullary cancers still spread to peripancreatic lymph nodes, so node status is not the explanation. Both are epithelial adenocarcinomas treated similarly with Whipple resection, and neither is meaningfully chemosensitive.
Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.