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What Causes Peri-ampullary Adenocarcinoma?

Posted on Tue, 12 Jul 2016

Question: Hi sir ,
My dads age is 49 and had diagnosed with periampullary adenocarcinoma on march 2016 and he underwent PPPD surgery on 14th April 2016.As per the histo pathology report he had positive 6 lymph nodes out of 14 lymphnodes taken.Tumor grade was well differentiated adenocarcinoma and Tumor invaded pancreatic tissue and duodenum wall with no lymphovascular invasion and perineural invasion and pancreatic neck margin is focally positive . Doctors told prognosis is not good as there is high risk of recurrence, now he is getting treated with adjuvant therapy with second cycle of chemotherapy of gemicitabine regimen.Can we cure this deadly disease inspite of lymphnodes involvement please opine?

Answered by Dr. Shailja Puri (32 minutes later)

Brief Answer
Negative lymphovascular invasion is a good prognostic factor
Detailed Answer:
Hello,
Thanks for posting your query on HealthcareMagic.
Peri-ampullary adenocarcinoma is deadly tumor no doubt.
However, there are certain prognostic factors which affect the prognosis and 5 year survival.
Absence of lympho-vascular invasion is a godd prognostic factor.
Presence of 6/14 positive lymph nodes is a poor prognostic factor, however, surgical excision and chemotherapy are the treatment of choice.
Chemotherapy needs to be continued as per oncologists.
Regular follow up after completion of chemotherapy will help to identify any recurrence in future.

Thanks and take care
Dr Shailja Puri

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Shailja Puri (38 minutes later)

Thanks for the reply mam. If there isany recurrence when can it reccur?

Answered by Dr. Shailja Puri (53 minutes later)

Brief Answer:
Recurrence of disease cannot be predicted.

Detailed Answer:
Hello and welcome again,
It is not possible to predict when the recurrence will occur.
However, a regular follow up is required.

Thanks and take care
Dr Shailja Puri

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Shailja Puri (6 hours later)

Hello mam, I would like to know whether Periampullary carcinoma, is ia type of pancreatic cancer or different cancer all togethe

Answered by Dr. Shailja Puri (11 hours later)

Brief Answer:
Per-ampularry tumor is an intestinal tumor not a pancreatic tumor.

Detailed Answer:
Hello and welcome again,
Peri-ampullary carcinoma is a small intestinal tumor.
It lies in close proximity to pancreas but it is not a pancreatic tumor.

Thanks and take care
Dr Shailja Puri

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Above answer was peer-reviewed by : Dr. Yogesh D