Among the four periampullary cancers, namely carcinoma of the head of pancreas, distal cholangiocarcinoma, ampulla of Vater carcinoma, and duodenal carcinoma, which one carries the best overall prognosis after pancreaticoduodenectomy?
- A Carcinoma of the head of pancreas
- B Ampullary carcinoma ✓
- C Distal cholangiocarcinoma
- D Duodenal adenocarcinoma
Correct answer: B. Ampullary carcinoma
Explanation
Ampullary carcinoma has the best prognosis among periampullary tumours, with 5-year survival approaching 40 percent or better, compared with roughly 20 percent for pancreatic head cancer. The reason is early obstructive jaundice from the small luminal ampulla, which leads to diagnosis at a lower T stage, and a higher proportion of intestinal-type histology, which behaves better than the pancreatobiliary subtype. Distal cholangiocarcinoma and duodenal cancer fall intermediate between these two.
Reference: Sabiston Textbook of Surgery, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.