Materiały źródłowe

• #1 The Diagnosis and Treatment of Ampullary Carcinoma

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10714289/

  Ampullary carcinoma has an incidence of 0.5 to 0.9 per 100 000 persons and a poor prognosis, with a 5-year survival rate of 41% to 45% for locally confined and 4% to 7% for metastatic disease. […] The treatment of choice for ampullary carcinoma is radical oncological resection of the head of the pancreas with systematic lymphadenectomy. Five-year overall survival is between 10% and 75% depending on the stage. […] The current state of the evidence on the treatment of ampullary carcinoma is poor. […] The treatment of choice is resection by means of pylorus preserving resection of the head of the pancreas in the early stages and systemic therapy in irresectable tumors. […] The role of resection of metachronous metastases is not clear at this time and was studied by Saedon et al in a meta-analysis.

• #2 Ampullary Cancer: Symptoms, Diagnosis & Outlook

  https://my.clevelandclinic.org/health/diseases/21905-ampullary-cancer

  Ampullary cancer is a rare and aggressive type of carcinoma that forms in an area of your body called the ampulla of Vater. […] Treatments include surgery, chemotherapy and radiation therapy. […] Because the first sign of ampullary cancer is usually jaundice, yellowing of the skin is often the reason healthcare providers begin testing for the disease. […] Tests to diagnose ampullary cancer include: Blood or urine tests to check for tumor markers. Imaging tests that use machines outside of your body to check for tumors inside of your body. Tests may include CT (computed tomography) scans, ultrasounds or magnetic resonance cholangiopancreatography (MRCP). Endoscopic tests that use a long, slender tube with a camera (endoscope) to access the tumor up close. Tests may include upper endoscopy and endoscopic retrograde cholangiopancreatography (ERCP). You’ll be sedated for these procedures, so you won’t feel any pain. A biopsy, which involves collecting a small tissue sample that a pathologist can test for cancer cells. Providers often collect the sample during an endoscopic test.

• #3 Diagnosis of biliary tract and ampullary carcinomas

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2794353/

  Diagnostic methods for biliary tract carcinoma and the efficacy of these methods are discussed. Neither definite methods for early diagnosis nor specific markers are available in this disease. When this disease is suspected on the basis of clinical symptoms and risk factors, hemato-biochemical examination and abdominal ultrasonography are performed and, where appropriate, enhanced computed tomography (CT) and/or magnetic resonance cholangiopancreatography (MRCP) is carried out. Diagnoses of extrahepatic bile duct cancer and ampullary carcinoma are often made based on the presence of obstructive jaundice. […] The clinical symptoms frequently encountered in ampullary carcinoma are jaundice, pyrexia, abdominal pain followed by general lassitude, weight loss, anorexia, and back pain. Jaundice is reported to be observed in 72%90% of these patients911 (levels IV, VI), but it is characterized by occasional fluctuation11 (level VI).

• #4 Ampullary Cancer | Cedars-Sinai

  https://www.cedars-sinai.org/health-library/diseases-and-conditions/a/ampullary-cancer.html

  Ampullary cancer is a rare type of cancer. […] Ampullary cancer may also be called ampulla of Vater cancer. […] The most common symptom of this cancer is jaundice. This is yellowing of the skin and eyes. It happens because the tumor in the ampulla of Vater blocks the bile duct. […] Many of these symptoms may be caused by other health problems. So its important to see your healthcare provider if you have these symptoms. Your provider will do exams and specific testing to find out if you have cancer. […] Jaundice is the most common symptom of this cancer. Its often what leads people to see a healthcare provider. Your provider will ask you about your health history, symptoms, risk factors, and family history of disease. They will do a physical exam. […] You may also have one or more of these tests: Blood and urine tests. These are used to look for anemia, bilirubin levels, and other changes that may be signs of this cancer. Imaging tests. These can be used to look for a tumor inside the ampulla of Vater. They may be ultrasounds or CT or MRI scans. Endoscopy. Healthcare providers may use an endoscope to look at the ampulla. An endoscope is a long, thin tube. It has a tiny video camera on the end. Its threaded down the mouth, through the esophagus and stomach, and into the duodenum to the ampulla. It can also be used to remove small tissue samples that will be examined in a lab to find out if cancer cells are present. Endoscopic retrograde cholangiopancreatography (ERCP). This test might be used to look at the pancreatic and bile ducts to see if they are blocked.

• #5 Diagnosis of biliary tract and ampullary carcinomas

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2794353/

  Diagnostic methods for biliary tract carcinoma and the efficacy of these methods are discussed. Neither definite methods for early diagnosis nor specific markers are available in this disease. When this disease is suspected on the basis of clinical symptoms and risk factors, hemato-biochemical examination and abdominal ultrasonography are performed and, where appropriate, enhanced computed tomography (CT) and/or magnetic resonance cholangiopancreatography (MRCP) is carried out. Diagnoses of extrahepatic bile duct cancer and ampullary carcinoma are often made based on the presence of obstructive jaundice. […] The clinical symptoms frequently encountered in ampullary carcinoma are jaundice, pyrexia, abdominal pain followed by general lassitude, weight loss, anorexia, and back pain. Jaundice is reported to be observed in 72%90% of these patients911 (levels IV, VI), but it is characterized by occasional fluctuation11 (level VI).

• #6 Ampullary Cancer

  https://healthlibrary.touro.com/wellness/Cholesterol/Tools/134,37

  Ampullary cancer is a rare type of cancer. It occurs when cancer starts in the part of the body called the ampulla of Vater. The most common symptom of this cancer is jaundice. This is yellowing of the skin and eyes. It happens because the tumor in the ampulla of Vater blocks the bile duct. Many of these symptoms may be caused by other health problems. So its important to see your healthcare provider if you have these symptoms. Your provider will do exams and specific testing to find out if you have cancer. […] Jaundice is the most common symptom of this cancer. Its often what leads people to see a healthcare provider. Your provider will ask you about your health history, symptoms, risk factors, and family history of disease. They will do a physical exam. You may also have one or more of these tests: Blood and urine tests. These are used to look for anemia, bilirubin levels, and other changes that may be signs of this cancer. Imaging tests. These can be used to look for a tumor inside the ampulla of Vater. They may be ultrasounds or CT or MRI scans. Endoscopy. Healthcare providers may use an endoscope to look at the ampulla. An endoscope is a long, thin tube. It has a tiny video camera on the end. Its threaded down the mouth, through the esophagus and stomach, and into the duodenum to the ampulla. It can also be used to remove small tissue samples that will be examined in a lab to find out if cancer cells are present. Endoscopic retrograde cholangiopancreatography (ERCP). This test might be used to look at the pancreatic and bile ducts to see if they are blocked.

• #7 Ampullary Cancer

  https://encyclopedia.nm.org/Library/HealthSheets/134,37

  Jaundice is the most common symptom of this cancer. Its often what leads people to see a healthcare provider. Your provider will ask you about your health history, symptoms, risk factors, and family history of disease. They will do a physical exam. […] You may also have one or more of these tests: […] Blood and urine tests. These are used to look for anemia, bilirubin levels, and other changes that may be signs of this cancer. […] Imaging tests. These can be used to look for a tumor inside the ampulla of Vater. They may be ultrasounds or CT or MRI scans. […] Endoscopy. Healthcare providers may use an endoscope to look at the ampulla. An endoscope is a long, thin tube. It has a tiny video camera on the end. Its threaded down the mouth, through the esophagus and stomach, and into the duodenum to the ampulla. It can also be used to remove small tissue samples that will be examined in a lab to find out if cancer cells are present.

• #8 Ampullary Cancer | Cedars-Sinai

  https://www.cedars-sinai.org/health-library/diseases-and-conditions/a/ampullary-cancer.html

  Ampullary cancer is a rare type of cancer. […] Ampullary cancer may also be called ampulla of Vater cancer. […] The most common symptom of this cancer is jaundice. This is yellowing of the skin and eyes. It happens because the tumor in the ampulla of Vater blocks the bile duct. […] Many of these symptoms may be caused by other health problems. So its important to see your healthcare provider if you have these symptoms. Your provider will do exams and specific testing to find out if you have cancer. […] Jaundice is the most common symptom of this cancer. Its often what leads people to see a healthcare provider. Your provider will ask you about your health history, symptoms, risk factors, and family history of disease. They will do a physical exam. […] You may also have one or more of these tests: Blood and urine tests. These are used to look for anemia, bilirubin levels, and other changes that may be signs of this cancer. Imaging tests. These can be used to look for a tumor inside the ampulla of Vater. They may be ultrasounds or CT or MRI scans. Endoscopy. Healthcare providers may use an endoscope to look at the ampulla. An endoscope is a long, thin tube. It has a tiny video camera on the end. Its threaded down the mouth, through the esophagus and stomach, and into the duodenum to the ampulla. It can also be used to remove small tissue samples that will be examined in a lab to find out if cancer cells are present. Endoscopic retrograde cholangiopancreatography (ERCP). This test might be used to look at the pancreatic and bile ducts to see if they are blocked.

• #9 Ampullary Carcinoma Workup: Approach Considerations, Laboratory Studies, Imaging Studies

  https://emedicine.medscape.com/article/276413-workup

  In the workup of ampullary carcinoma, diagnostic modalities of choice are as follows: Endoscopic ultrasound (EUS), Endoscopic retrograde cholangiopancreatography (ERCP), Fine-needle aspiration cytology (FNAC). […] Staging of ampullary carcinoma requires computed tomography (CT) of the chest, abdomen, and pelvis. Endoscopic ampullectomy may be part of the diagnostic process and may be curative in highly selected cases (eg, early ampullary carcinoma, in situ carcinoma, low-grade dysplasia). […] CA 19-9 is a serum tumor marker that is often elevated in pancreatic malignancies and might have a role in assessing response to therapy, predicting tumor recurrence, or both. […] In one series comparing the accuracy of EUS and CT for staging of ampullary cancer, EUS demonstrated a better sensitivity, specificity, positive predictive value, and negative predictive value stage for stage.

• #10 Ampullary Carcinoma Workup: Approach Considerations, Laboratory Studies, Imaging Studies

  https://emedicine.medscape.com/article/276413-workup

  In the workup of ampullary carcinoma, diagnostic modalities of choice are as follows: Endoscopic ultrasound (EUS), Endoscopic retrograde cholangiopancreatography (ERCP), Fine-needle aspiration cytology (FNAC). […] Staging of ampullary carcinoma requires computed tomography (CT) of the chest, abdomen, and pelvis. Endoscopic ampullectomy may be part of the diagnostic process and may be curative in highly selected cases (eg, early ampullary carcinoma, in situ carcinoma, low-grade dysplasia). […] CA 19-9 is a serum tumor marker that is often elevated in pancreatic malignancies and might have a role in assessing response to therapy, predicting tumor recurrence, or both. […] In one series comparing the accuracy of EUS and CT for staging of ampullary cancer, EUS demonstrated a better sensitivity, specificity, positive predictive value, and negative predictive value stage for stage.

• #11 Diagnosis of biliary tract and ampullary carcinomas

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2794353/

  Noninvasive abdominal ultrasonography and hematological examination can be the first step in diagnosis (recommendation B). […] The diagnostic imaging to be performed in the first place is abdominal US when biliary tract cancer is suspected. […] CT and MRI (including MRCP) are useful for localization of the lesion and assessment of the degree of its extension (recommendation B). Also, direct cholangiography is useful for the diagnosis of the horizontal extension of bile duct cancer (recommendation C1). […] Tissue biopsy is conducted for tumor of the papilla (recommendation B). CT and MRI are performed for the diagnosis of distant metastasis and lymph node metastasis (recommendation B). Intraductal ultrasonography (IDUS) and EUS are useful for diagnosis of pancreatic and duodenal invasions (recommendation C1).

• #12 Ampullary Cancer: Symptoms, Diagnosis & Outlook

  https://my.clevelandclinic.org/health/diseases/21905-ampullary-cancer

  Ampullary cancer is a rare and aggressive type of carcinoma that forms in an area of your body called the ampulla of Vater. […] Treatments include surgery, chemotherapy and radiation therapy. […] Because the first sign of ampullary cancer is usually jaundice, yellowing of the skin is often the reason healthcare providers begin testing for the disease. […] Tests to diagnose ampullary cancer include: Blood or urine tests to check for tumor markers. Imaging tests that use machines outside of your body to check for tumors inside of your body. Tests may include CT (computed tomography) scans, ultrasounds or magnetic resonance cholangiopancreatography (MRCP). Endoscopic tests that use a long, slender tube with a camera (endoscope) to access the tumor up close. Tests may include upper endoscopy and endoscopic retrograde cholangiopancreatography (ERCP). You’ll be sedated for these procedures, so you won’t feel any pain. A biopsy, which involves collecting a small tissue sample that a pathologist can test for cancer cells. Providers often collect the sample during an endoscopic test.

• #13 Ampullary Cancer

  https://encyclopedia.nm.org/Library/HealthSheets/134,37

  Jaundice is the most common symptom of this cancer. Its often what leads people to see a healthcare provider. Your provider will ask you about your health history, symptoms, risk factors, and family history of disease. They will do a physical exam. […] You may also have one or more of these tests: […] Blood and urine tests. These are used to look for anemia, bilirubin levels, and other changes that may be signs of this cancer. […] Imaging tests. These can be used to look for a tumor inside the ampulla of Vater. They may be ultrasounds or CT or MRI scans. […] Endoscopy. Healthcare providers may use an endoscope to look at the ampulla. An endoscope is a long, thin tube. It has a tiny video camera on the end. Its threaded down the mouth, through the esophagus and stomach, and into the duodenum to the ampulla. It can also be used to remove small tissue samples that will be examined in a lab to find out if cancer cells are present.

• #14 Ampullary Carcinoma Workup: Approach Considerations, Laboratory Studies, Imaging Studies

  https://emedicine.medscape.com/article/276413-workup

  Obtain ERCP to evaluate the ductal architecture further. The following findings on ERCP suggest pancreatic cancer: Irregular pancreatic duct narrowing, Displacement of the main pancreatic duct, Destruction or displacement of the side branches of the duct, Pooling of contrast material in necrotic areas of tumor. […] Positron emission tomography (PET) or PET-CT scans have been widely adopted in the author’s clinic as a means of imaging the metabolic activity of a particular tumor. PET or PET-CT scans can detect metastases that are too small to be reliably detected on a CT scan. […] The currently accepted American Joint Committee on Cancer staging system (8th edition) for ampullary carcinoma emphasizes the importance of pancreatic invasion and lymph node metastases.

• #15 Diagnosis of biliary tract and ampullary carcinomas

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2794353/

  Noninvasive abdominal ultrasonography and hematological examination can be the first step in diagnosis (recommendation B). […] The diagnostic imaging to be performed in the first place is abdominal US when biliary tract cancer is suspected. […] CT and MRI (including MRCP) are useful for localization of the lesion and assessment of the degree of its extension (recommendation B). Also, direct cholangiography is useful for the diagnosis of the horizontal extension of bile duct cancer (recommendation C1). […] Tissue biopsy is conducted for tumor of the papilla (recommendation B). CT and MRI are performed for the diagnosis of distant metastasis and lymph node metastasis (recommendation B). Intraductal ultrasonography (IDUS) and EUS are useful for diagnosis of pancreatic and duodenal invasions (recommendation C1).

• #16 Ampullary Carcinoma Workup: Approach Considerations, Laboratory Studies, Imaging Studies

  https://emedicine.medscape.com/article/276413-workup

  In the workup of ampullary carcinoma, diagnostic modalities of choice are as follows: Endoscopic ultrasound (EUS), Endoscopic retrograde cholangiopancreatography (ERCP), Fine-needle aspiration cytology (FNAC). […] Staging of ampullary carcinoma requires computed tomography (CT) of the chest, abdomen, and pelvis. Endoscopic ampullectomy may be part of the diagnostic process and may be curative in highly selected cases (eg, early ampullary carcinoma, in situ carcinoma, low-grade dysplasia). […] CA 19-9 is a serum tumor marker that is often elevated in pancreatic malignancies and might have a role in assessing response to therapy, predicting tumor recurrence, or both. […] In one series comparing the accuracy of EUS and CT for staging of ampullary cancer, EUS demonstrated a better sensitivity, specificity, positive predictive value, and negative predictive value stage for stage.

• #17 Ampullary Cancer: Symptoms, Diagnosis & Outlook

  https://my.clevelandclinic.org/health/diseases/21905-ampullary-cancer

  Ampullary cancer is a rare and aggressive type of carcinoma that forms in an area of your body called the ampulla of Vater. […] Treatments include surgery, chemotherapy and radiation therapy. […] Because the first sign of ampullary cancer is usually jaundice, yellowing of the skin is often the reason healthcare providers begin testing for the disease. […] Tests to diagnose ampullary cancer include: Blood or urine tests to check for tumor markers. Imaging tests that use machines outside of your body to check for tumors inside of your body. Tests may include CT (computed tomography) scans, ultrasounds or magnetic resonance cholangiopancreatography (MRCP). Endoscopic tests that use a long, slender tube with a camera (endoscope) to access the tumor up close. Tests may include upper endoscopy and endoscopic retrograde cholangiopancreatography (ERCP). You’ll be sedated for these procedures, so you won’t feel any pain. A biopsy, which involves collecting a small tissue sample that a pathologist can test for cancer cells. Providers often collect the sample during an endoscopic test.

• #18 Ampullary Cancer

  https://encyclopedia.nm.org/Library/HealthSheets/134,37

  Jaundice is the most common symptom of this cancer. Its often what leads people to see a healthcare provider. Your provider will ask you about your health history, symptoms, risk factors, and family history of disease. They will do a physical exam. […] You may also have one or more of these tests: […] Blood and urine tests. These are used to look for anemia, bilirubin levels, and other changes that may be signs of this cancer. […] Imaging tests. These can be used to look for a tumor inside the ampulla of Vater. They may be ultrasounds or CT or MRI scans. […] Endoscopy. Healthcare providers may use an endoscope to look at the ampulla. An endoscope is a long, thin tube. It has a tiny video camera on the end. Its threaded down the mouth, through the esophagus and stomach, and into the duodenum to the ampulla. It can also be used to remove small tissue samples that will be examined in a lab to find out if cancer cells are present.

• #19 Endoscopic Diagnosis of Ampullary Tumors Using Conventional Endoscopic Ultrasonography and Intraductal Ultrasonography in the Era of Endoscopic Papillectomy: Advantages and Limitations

  https://www.e-ce.org/journal/view.php?number=6597

  Therefore, further investigation with another endoscopic modality in conjunction with duodenoscopic evaluation is needed to identify ampullary lesions suitable for endoscopic resection. […] The overall diagnostic accuracy was the same (85%) for both EUS and IDUS. […] Diagnostic accuracies for ampullary adenoma or pTis cancer and T1 early-stage cancer were similar with 97% and 73% for EUS, and 94% and 73% for IDUS, respectively. […] Accurate T-staging of ampullary cancer and involvement of the biliopancreatic ductal system are the most important factors that guide appropriate therapy. […] There is still no consensus on the indication for EP of ampullary tumors. However, ampullary adenoma, high-grade dysplasia, and Tis without ductal involvement are absolute indications for EP. […] Therefore, T1 cancer and cancer focally limited to the major papilla can be relative indications for EP in cases without lymph node metastasis.

• #20 Ampullary Carcinoma Workup: Approach Considerations, Laboratory Studies, Imaging Studies

  https://emedicine.medscape.com/article/276413-workup

  In the workup of ampullary carcinoma, diagnostic modalities of choice are as follows: Endoscopic ultrasound (EUS), Endoscopic retrograde cholangiopancreatography (ERCP), Fine-needle aspiration cytology (FNAC). […] Staging of ampullary carcinoma requires computed tomography (CT) of the chest, abdomen, and pelvis. Endoscopic ampullectomy may be part of the diagnostic process and may be curative in highly selected cases (eg, early ampullary carcinoma, in situ carcinoma, low-grade dysplasia). […] CA 19-9 is a serum tumor marker that is often elevated in pancreatic malignancies and might have a role in assessing response to therapy, predicting tumor recurrence, or both. […] In one series comparing the accuracy of EUS and CT for staging of ampullary cancer, EUS demonstrated a better sensitivity, specificity, positive predictive value, and negative predictive value stage for stage.

• #21 Ampullary Cancer

  https://encyclopedia.nm.org/Library/HealthSheets/134,37

  Endoscopic retrograde cholangiopancreatography (ERCP). This test might be used to look at the pancreatic and bile ducts to see if they are blocked. […] It can be hard to tell the difference between pancreatic cancer and ampullary cancer. A biopsy is the only way to confirm this cancer. Small tissue samples are removed then examined under a microscope in a lab to find out the type of cancer cells present. […] After a diagnosis of ampullary cancer, you’ll likely need more tests. These help your healthcare providers learn more about the cancer. They can help find out the stage of cancer. The stage is how much and how far the cancer has spread (metastasized) in your body. Its one of the most important things to know when deciding how to treat the cancer. […] Once your cancer is staged, your healthcare provider will talk with you about what the stage means for your treatment. Ask your provider to explain the stage of your cancer to you in a way you can understand.

• #22 Ampullary cancer: 9 things to know about this rare gastrointestinal cancer | MD Anderson Cancer Center

  https://www.mdanderson.org/cancerwise/ampullary-cancer-9-insights-on-this-rare-gastrointestinal-cancer.h00-159542112.html

  Ampullary cancer is a rare type of gastrointestinal cancer with symptoms so similar to pancreatic cancer that it is sometimes mistaken for the disease. The definitive way to confirm an ampullary cancer diagnosis is by removing a tissue sample from the tumor, then analyzing it in the lab. […] A tumor tissue biopsy can provide a definitive diagnosis. Other tests can help doctors stage the cancer and develop a treatment plan. These include: CT scans, MRIs or ultrasounds to identify the size and location of tumors, Endoscopy, to remove small tissue samples from the ampulla of Vater for biopsy, Endoscopic retrograde cholangiopancreatography (ERCP), to determine if the pancreatic or bile ducts are blocked.

• #23 Ampullary Adenocarcinoma, Version 1.2023, NCCN Clinical Practice Guidelines in Oncology in: Journal of the National Comprehensive Cancer Network Volume 21 Issue 7 (2023)

  https://jnccn.org/abstract/journals/jnccn/21/7/article-p753.xml

  Endoscopic biopsies of ampullary adenocarcinoma have shown poor diagnostic accuracy, with high false-negative rates reported in the literature (20%40%). […] EUS and CT are commonly used imaging techniques in the initial diagnosis and subsequent staging of ampullary neoplasms, with EUS noted as the more specific and sensitive modality in several small, single-institution, prospective studies. […] Patients presenting with ampullary adenocarcinoma should receive further workup consisting of chest CT, pancreas protocol CT of abdomen/pelvis, liver function tests, and detection of baseline CA 19-9 and CEA. […] Genetic testing for inherited mutations can be considered, with the same recommendations as those found in the NCCN Guidelines for Pancreatic Adenocarcinoma. […] Molecular profiling of tumor tissue should be performed with the same considerations as those found in the NCCN Guidelines for Pancreatic Adenocarcinoma.

• #24 Ampullary cancer – Augusta HealthSearchClose SearchSearch IconSearch IconClose Search IconMobile Menu IconMobile Menu Close IconInstagramFacebookTwitterYoutube

  https://www.augustahealth.com/disease/ampullary-cancer/

  Tests and procedures used to diagnose ampullary cancer include: […] Imaging tests may help your doctor understand more about your cancer and determine whether it has spread beyond the ampulla of Vater. Imaging tests may include endoscopic ultrasound, endoscopic retrograde cholangiopancreatography, magnetic resonance cholangiopancreatography and computerized tomography. […] A sample of cancer cells removed during endoscopy or surgery can be analyzed in the lab to look for characteristics that might guide treatment and prognosis.

• #25 The Diagnosis and Treatment of Ampullary Carcinoma (27.10.2023)

  https://di.aerzteblatt.de/int/archive/article/234965

  The ICD-10 code for ampullary carcinomas is C24.1; the cancer data from the RKI have to date not reported a separate incidence. […] The age when people originally became ill was between 40 and 70 years in both men and women, and about 50% of patients presented at an advanced that is, metastasized or non-resectable stage. […] Five-year survival rates varied between 10% and 75% in the localized stage and 4.7% in the metastatic stage. […] The intestinal subtype is often found in addition to parts of a duodenal adenoma and shows histomorphologic parallels to colon cancer, whereas the pancreaticobiliary subtype resembles the growth pattern in pancreatic cancers and cholangiocarcinoma. […] The great clinical relevance of subtyping is reflected in a relevant effect on the prognosis: survival in pancreaticobiliary carcinoma seems notably worse (median 3341 months) than for the intestinal subtype (7280 months).

• #26 Ampullary Carcinoma Workup: Approach Considerations, Laboratory Studies, Imaging Studies

  https://emedicine.medscape.com/article/276413-workup

  Obtain ERCP to evaluate the ductal architecture further. The following findings on ERCP suggest pancreatic cancer: Irregular pancreatic duct narrowing, Displacement of the main pancreatic duct, Destruction or displacement of the side branches of the duct, Pooling of contrast material in necrotic areas of tumor. […] Positron emission tomography (PET) or PET-CT scans have been widely adopted in the author’s clinic as a means of imaging the metabolic activity of a particular tumor. PET or PET-CT scans can detect metastases that are too small to be reliably detected on a CT scan. […] The currently accepted American Joint Committee on Cancer staging system (8th edition) for ampullary carcinoma emphasizes the importance of pancreatic invasion and lymph node metastases.

• #27 Periampullary Tumors | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/17482

  Ampullary cancer arises from ampulla of Vater terminal to the confluence of the distal common bile duct (CBD) and the pancreatic duct. […] The diagnosis is established with endoscopic ultrasound / Endoscopic retrograde cholangiopancreatography (ERCP) and fine-needle aspiration cytology (FNAC). […] All patients diagnosed with ampullary cancers need staging evaluation with computerized tomography (CT) of chest, abdomen, and pelvis. […] The common presenting symptom at the time of diagnosis is obstructive jaundice due to distal biliary ductal blockage, which prompts further evaluation for diagnosis. […] The TNM system of the American Joint Committee on Cancer (AJCC) is used to stage these cancers. […] The only curative potential treatment modality for ampullary cancer is surgical resection with pancreaticoduodenectomy/Whipple with or without preserving the pylorus.

• #28 Periampullary Tumors | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/17482

  Ampullary cancer patients with T2 or above stage or lymph node-positive tumors are associated with increased recurrence risk and therefore, could be benefitted from adjuvant treatment. […] The American Joint Committee on Cancer staging system uses the TNM system. […] The prognostic outcome is dependent upon the extent of local invitation, the status of surgical margins after the definitive surgery, and the presence of nodal metastasis. […] There are no specific guidelines existing for post-treatment surveillance.

• #29 Ampullary Cancer: Symptoms, Staging and Survival Rate

  https://www.cancercenter.com/cancer-types/ampullary-cancer

  Generally, ampullary cancer is diagnosed in patients 70 and older, but it may also occur earlier in patients with pre-existing health conditions. […] Two common methods that doctors use to diagnose ampullary cancer are: […] Endoscopic ultrasound: An ultrasound combined with X-rays allows a doctor to look for the presence of a tumor. If a tumor is found, the doctor will then perform a biopsy to examine the tissue sample under a microscope and look for the presence of cancer cells. […] CT scan: This imaging tool takes clear pictures of the inside of the body. Doctors use this to stage the cancer to see whether its spread. […] Doctors use the TNM system to diagnose ampullary cancer. This system provides concrete knowledge about the cancer, such as the size of the tumor and whether its spread to any other parts of the body. […] Together, the three elements of the TNM system make for an effective way to understand more about a patients cancer and to identify appropriate treatment options.

• #30 Ampullary cancer: 9 things to know about this rare gastrointestinal cancer | MD Anderson Cancer Center

  https://www.mdanderson.org/cancerwise/ampullary-cancer-9-insights-on-this-rare-gastrointestinal-cancer.h00-159542112.html

  Ampullary cancer is a rare type of gastrointestinal cancer with symptoms so similar to pancreatic cancer that it is sometimes mistaken for the disease. The definitive way to confirm an ampullary cancer diagnosis is by removing a tissue sample from the tumor, then analyzing it in the lab. […] A tumor tissue biopsy can provide a definitive diagnosis. Other tests can help doctors stage the cancer and develop a treatment plan. These include: CT scans, MRIs or ultrasounds to identify the size and location of tumors, Endoscopy, to remove small tissue samples from the ampulla of Vater for biopsy, Endoscopic retrograde cholangiopancreatography (ERCP), to determine if the pancreatic or bile ducts are blocked.

• #31 Ampullary Cancer: Symptoms, Diagnosis & Outlook

  https://my.clevelandclinic.org/health/diseases/21905-ampullary-cancer

  Ampullary cancer is a rare and aggressive type of carcinoma that forms in an area of your body called the ampulla of Vater. […] Treatments include surgery, chemotherapy and radiation therapy. […] Because the first sign of ampullary cancer is usually jaundice, yellowing of the skin is often the reason healthcare providers begin testing for the disease. […] Tests to diagnose ampullary cancer include: Blood or urine tests to check for tumor markers. Imaging tests that use machines outside of your body to check for tumors inside of your body. Tests may include CT (computed tomography) scans, ultrasounds or magnetic resonance cholangiopancreatography (MRCP). Endoscopic tests that use a long, slender tube with a camera (endoscope) to access the tumor up close. Tests may include upper endoscopy and endoscopic retrograde cholangiopancreatography (ERCP). You’ll be sedated for these procedures, so you won’t feel any pain. A biopsy, which involves collecting a small tissue sample that a pathologist can test for cancer cells. Providers often collect the sample during an endoscopic test.

• #32 The Diagnosis and Treatment of Ampullary Carcinoma

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10714289/

  Ampullary carcinoma has an incidence of 0.5 to 0.9 per 100 000 persons and a poor prognosis, with a 5-year survival rate of 41% to 45% for locally confined and 4% to 7% for metastatic disease. […] The treatment of choice for ampullary carcinoma is radical oncological resection of the head of the pancreas with systematic lymphadenectomy. Five-year overall survival is between 10% and 75% depending on the stage. […] The current state of the evidence on the treatment of ampullary carcinoma is poor. […] The treatment of choice is resection by means of pylorus preserving resection of the head of the pancreas in the early stages and systemic therapy in irresectable tumors. […] The role of resection of metachronous metastases is not clear at this time and was studied by Saedon et al in a meta-analysis.

• #33 Ampullary Cancer

  https://encyclopedia.nm.org/Library/HealthSheets/134,37

  Endoscopic retrograde cholangiopancreatography (ERCP). This test might be used to look at the pancreatic and bile ducts to see if they are blocked. […] It can be hard to tell the difference between pancreatic cancer and ampullary cancer. A biopsy is the only way to confirm this cancer. Small tissue samples are removed then examined under a microscope in a lab to find out the type of cancer cells present. […] After a diagnosis of ampullary cancer, you’ll likely need more tests. These help your healthcare providers learn more about the cancer. They can help find out the stage of cancer. The stage is how much and how far the cancer has spread (metastasized) in your body. Its one of the most important things to know when deciding how to treat the cancer. […] Once your cancer is staged, your healthcare provider will talk with you about what the stage means for your treatment. Ask your provider to explain the stage of your cancer to you in a way you can understand.

• #34 Ampullary cancer: Symptoms, treatment, and outlook

  https://www.medicalnewstoday.com/articles/ampullary-cancer

  Ampullary cancer is a rare form of cancer that develops in the ampulla of Vater. […] Ampullary cancer is a relatively rare form of cancer. It accounts for about 6% of all cancers that develop in the periampullary area. […] Diagnosis may be difficult. This is because ampullary cancer resembles several other local cancers, including pancreatic cancer, distal biliary ductal cancer, and colon cancer. […] A doctor will likely use a few tests to help make a diagnosis. The tests can include: endoscopic ultrasound, endoscopic retrograde cholangiopancreatography, fine-needle aspiration cytology. […] The diagnostic process also involves staging the cancer. To do this, a doctor will typically order a CT scan of the abdomen, chest, and pelvis.

• #35 Ampullary Cancer

  https://encyclopedia.nm.org/Library/HealthSheets/134,37

  Endoscopic retrograde cholangiopancreatography (ERCP). This test might be used to look at the pancreatic and bile ducts to see if they are blocked. […] It can be hard to tell the difference between pancreatic cancer and ampullary cancer. A biopsy is the only way to confirm this cancer. Small tissue samples are removed then examined under a microscope in a lab to find out the type of cancer cells present. […] After a diagnosis of ampullary cancer, you’ll likely need more tests. These help your healthcare providers learn more about the cancer. They can help find out the stage of cancer. The stage is how much and how far the cancer has spread (metastasized) in your body. Its one of the most important things to know when deciding how to treat the cancer. […] Once your cancer is staged, your healthcare provider will talk with you about what the stage means for your treatment. Ask your provider to explain the stage of your cancer to you in a way you can understand.

• #36 Ampullary tumor | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/ampullary-tumour?lang=us

  The term ampullary tumor generally refers to either benign or malignant neoplasms that arise from the glandular epithelium of the ampulla of Vater, including ampullary adenoma (adenoma of ampulla of Vater) and ampullary carcinoma (carcinoma of ampulla of Vater). […] In general, ampullary tumors tend to show a better prognosis than their biliary or periampullary counterparts, as they can be detected at an earlier stage owing to earlier presentation due to biliary obstruction. […] Diagnosis of Biliary Tract and Ampullary Carcinomas.

• #37 Ampullary adenocarcinoma | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/ampullary-adenocarcinoma?lang=us

  Ampullary adenocarcinomas are rare biliary tumors arising from the distal biliary epithelium at the ampulla of Vater. […] Although classically presenting on imaging with the double duct sign, the tumor itself may be occult or of limited characterization on imaging. […] Ultrasound, CT, and MRI may demonstrate the double duct sign (simultaneous dilatation of the common bile and pancreatic ducts) which is seen in ~52% of cases. […] MRCP has been described as more sensitive than other imaging modalities for depicting ampullary lesions, but has low specificity. […] Tumors that are occult on imaging are also frequently occult at ERCP/endoscopy, with the diagnosis only achieved after papillotomy/biopsy.

• #38 Ampullary Adenocarcinoma, Version 1.2023, NCCN Clinical Practice Guidelines in Oncology in: Journal of the National Comprehensive Cancer Network Volume 21 Issue 7 (2023)

  https://jnccn.org/abstract/journals/jnccn/21/7/article-p753.xml

  Endoscopic biopsies of ampullary adenocarcinoma have shown poor diagnostic accuracy, with high false-negative rates reported in the literature (20%40%). […] EUS and CT are commonly used imaging techniques in the initial diagnosis and subsequent staging of ampullary neoplasms, with EUS noted as the more specific and sensitive modality in several small, single-institution, prospective studies. […] Patients presenting with ampullary adenocarcinoma should receive further workup consisting of chest CT, pancreas protocol CT of abdomen/pelvis, liver function tests, and detection of baseline CA 19-9 and CEA. […] Genetic testing for inherited mutations can be considered, with the same recommendations as those found in the NCCN Guidelines for Pancreatic Adenocarcinoma. […] Molecular profiling of tumor tissue should be performed with the same considerations as those found in the NCCN Guidelines for Pancreatic Adenocarcinoma.

• #39 The Diagnosis and Treatment of Ampullary Carcinoma

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10714289/

  The poor prognosis even at the early resectable stage prompts the question of whether adjuvant therapeutic concepts can potentially improve the disease course. […] The observations of these prospective studies contrast with multiple retrospective analyses that partly also include the histologic subtype. […] The importance of adjuvant radiochemotherapy in ampullary carcinoma therefore remains unclear. […] In the palliative setting, molecular genetic and immunohistochemical analysis regarding microsatellite instability seems sensible.

• #40 The Diagnosis and Treatment of Ampullary Carcinoma

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10714289/

  The poor prognosis even at the early resectable stage prompts the question of whether adjuvant therapeutic concepts can potentially improve the disease course. […] The observations of these prospective studies contrast with multiple retrospective analyses that partly also include the histologic subtype. […] The importance of adjuvant radiochemotherapy in ampullary carcinoma therefore remains unclear. […] In the palliative setting, molecular genetic and immunohistochemical analysis regarding microsatellite instability seems sensible.

• #41

  https://www.karmanos.org/karmanos/ampullary-cancer-treated-at-karmanos

  Ampullary cancer is when cancer (malignant) cells start to grow within the ampulla of Vater. […] The most common symptom of ampullary cancer is jaundice, which is the yellowing of the skin and eyes. […] Although there is no standard screening for the general population, however, those with above mentioned inherited syndromes that increase the risk of this cancer may get screening upper endoscopy, CT scan, MRI or ultrasound periodically as indicated by their gastrointestinal doctor. […] If we see any tumor/mass on the ampulla then a biopsy is obtained to confirm the diagnosis. […] There are different treatment types for patients with ampullary and periampullary cancers including endoscopic surgery, Whipples procedure, radiation therapy, chemotherapy, targeted therapy and/or immunotherapy if indicated.

• #42

  https://www.karmanos.org/karmanos/ampullary-cancer-treated-at-karmanos

  Ampullary cancer is when cancer (malignant) cells start to grow within the ampulla of Vater. […] The most common symptom of ampullary cancer is jaundice, which is the yellowing of the skin and eyes. […] Although there is no standard screening for the general population, however, those with above mentioned inherited syndromes that increase the risk of this cancer may get screening upper endoscopy, CT scan, MRI or ultrasound periodically as indicated by their gastrointestinal doctor. […] If we see any tumor/mass on the ampulla then a biopsy is obtained to confirm the diagnosis. […] There are different treatment types for patients with ampullary and periampullary cancers including endoscopic surgery, Whipples procedure, radiation therapy, chemotherapy, targeted therapy and/or immunotherapy if indicated.

• #43 Get Ampullary Cancer Treatment | Cleveland Clinic

  https://my.clevelandclinic.org/services/ampullary-cancer-treatment

  At Cleveland Clinic, we encourage second opinions. Our highly skilled ampullary cancer team takes the time to help you understand whats happening, explain treatment options and offer their expertise, every step of the way. […] Cleveland Clinics team-based approach to care puts all of the expert providers you need on a highly personalized care team. They work together to confirm a diagnosis and build a treatment plan that focuses completely on you and your unique needs. […] The Whipple procedure (also called a pancreaticoduodenectomy) is the most common treatment for ampullary cancer. Your surgeon removes the tumor from the ampulla of Vater, your gallbladder, portions of your bile ducts and small intestine and the head of your pancreas. […] We may recommend chemotherapy or radiation therapy after surgery. These therapies reduce the risk of cancer returning. Or you may receive chemotherapy if cancer has spread widely or youre not healthy enough for surgery. Your care team may suggest both treatments as part of your plan.

• #44 Ampullary cancer | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/ampullary-cancer?content_id=CON-20213615

  Chemotherapy is sometimes used after surgery to kill cancer cells that might remain. In people with advanced ampullary cancer, chemotherapy may be used alone to slow the growth of the cancer. […] Immunotherapy is a treatment with medicine that helps the immune system kill cancer cells. […] If you have cancer, palliative care can help relieve pain and other symptoms. […] If your healthcare professional thinks you might have ampullary cancer, you may be referred to a specialist.

• #45 Get Ampullary Cancer Treatment | Cleveland Clinic

  https://my.clevelandclinic.org/services/ampullary-cancer-treatment

  At Cleveland Clinic, we encourage second opinions. Our highly skilled ampullary cancer team takes the time to help you understand whats happening, explain treatment options and offer their expertise, every step of the way. […] Cleveland Clinics team-based approach to care puts all of the expert providers you need on a highly personalized care team. They work together to confirm a diagnosis and build a treatment plan that focuses completely on you and your unique needs. […] The Whipple procedure (also called a pancreaticoduodenectomy) is the most common treatment for ampullary cancer. Your surgeon removes the tumor from the ampulla of Vater, your gallbladder, portions of your bile ducts and small intestine and the head of your pancreas. […] We may recommend chemotherapy or radiation therapy after surgery. These therapies reduce the risk of cancer returning. Or you may receive chemotherapy if cancer has spread widely or youre not healthy enough for surgery. Your care team may suggest both treatments as part of your plan.

• #46 Ampullary Cancer: Symptoms, Diagnosis & Outlook

  https://my.clevelandclinic.org/health/diseases/21905-ampullary-cancer

  The tests that allow healthcare providers to diagnose cancer also help with cancer staging. Staging gives information about how advanced the cancer is and what treatments will work best. Early-stage ampullary cancer responds better to treatment than cancer in advanced stages. […] Ampullary cancer treatment options include: Whipple procedure: This surgical procedure is the most common ampullary cancer treatment. Providers remove the tumor and nearby areas that may also contain cancer cells, like your gallbladder, part of your bile duct and small intestine, and the head of your pancreas. Endoscopic surgery: Providers sometimes remove early-stage ampullary cancers during an endoscopy. During surgery, providers remove cancer cells using tools inside the endoscope. Chemotherapy: Your provider may recommend cancer-killing drugs after surgery to eliminate any remaining cancer cells. Chemotherapy drugs can also slow tumor growth even if they can’t get rid of a tumor completely. Combined chemotherapy and radiation therapy: Radiation therapy uses powerful beams of energy to destroy cancer cells. You may need this treatment alongside chemotherapy before surgery to shrink your tumor. Or you may need it after surgery to kill remaining cancer cells. Palliative care: These treatments focus on reducing uncomfortable symptoms.

• #47 Get Ampullary Cancer Treatment | Cleveland Clinic

  https://my.clevelandclinic.org/services/ampullary-cancer-treatment

  At Cleveland Clinic, we encourage second opinions. Our highly skilled ampullary cancer team takes the time to help you understand whats happening, explain treatment options and offer their expertise, every step of the way. […] Cleveland Clinics team-based approach to care puts all of the expert providers you need on a highly personalized care team. They work together to confirm a diagnosis and build a treatment plan that focuses completely on you and your unique needs. […] The Whipple procedure (also called a pancreaticoduodenectomy) is the most common treatment for ampullary cancer. Your surgeon removes the tumor from the ampulla of Vater, your gallbladder, portions of your bile ducts and small intestine and the head of your pancreas. […] We may recommend chemotherapy or radiation therapy after surgery. These therapies reduce the risk of cancer returning. Or you may receive chemotherapy if cancer has spread widely or youre not healthy enough for surgery. Your care team may suggest both treatments as part of your plan.

• #48 Ampullary Cancer: Symptoms, Diagnosis & Outlook

  https://my.clevelandclinic.org/health/diseases/21905-ampullary-cancer

  The only potential cure for ampullary cancer is surgery that removes it completely. Curative treatments usually only work with early-stage cancers. […] The five-year survival rate for people who receive the Whipple procedure ranges from 35% to 62%. This means that up to 62 out of 100 people who had the Whipple procedure for ampullary cancer are still alive after five years.

• #49 Ampullary Cancer: Symptoms, Diagnosis & Outlook

  https://my.clevelandclinic.org/health/diseases/21905-ampullary-cancer

  The only potential cure for ampullary cancer is surgery that removes it completely. Curative treatments usually only work with early-stage cancers. […] The five-year survival rate for people who receive the Whipple procedure ranges from 35% to 62%. This means that up to 62 out of 100 people who had the Whipple procedure for ampullary cancer are still alive after five years.

• #50 Ampullary Cancer

  https://healthlibrary.bvhealthsystem.org/Library/DiseasesConditions/Pediatric/Diabetes/134,37

  The main treatment for ampullary cancer is surgery to remove the tumor. The Whipple procedure (also called a pancreaticoduodenectomy) is used. This is a major surgery where your surgeon removes the tumor in the affected part of the ampulla of Vater. […] Some healthcare providers may also advise other treatments after surgery, such as chemotherapy or radiation therapy.

• #51 Ampullary Cancer

  https://healthlibrary.brighamandwomens.org/library/PreventionGuidelines/134,37

  It can be hard to tell the difference between pancreatic cancer and ampullary cancer. A biopsy is the only way to confirm this cancer. Small tissue samples are removed then examined under a microscope in a lab to find out the type of cancer cells present. […] After a diagnosis of ampullary cancer, you’ll likely need more tests. These help your healthcare providers learn more about the cancer. They can help find out the stage of cancer. The stage is how much and how far the cancer has spread (metastasized) in your body. Its one of the most important things to know when deciding how to treat the cancer. […] The main treatment for ampullary cancer is surgery to remove the tumor. The Whipple procedure (also called a pancreaticoduodenectomy) is used. This is a major surgery where your surgeon removes the tumor in the affected part of the ampulla of Vater. Nearby tissues are often removed as well. These include the head of the pancreas, the lower half of the stomach, the duodenum, gallbladder, and lymph nodes.

• #52 Get Ampullary Cancer Treatment | Cleveland Clinic

  https://my.clevelandclinic.org/services/ampullary-cancer-treatment

  At Cleveland Clinic, we encourage second opinions. Our highly skilled ampullary cancer team takes the time to help you understand whats happening, explain treatment options and offer their expertise, every step of the way. […] Cleveland Clinics team-based approach to care puts all of the expert providers you need on a highly personalized care team. They work together to confirm a diagnosis and build a treatment plan that focuses completely on you and your unique needs. […] The Whipple procedure (also called a pancreaticoduodenectomy) is the most common treatment for ampullary cancer. Your surgeon removes the tumor from the ampulla of Vater, your gallbladder, portions of your bile ducts and small intestine and the head of your pancreas. […] We may recommend chemotherapy or radiation therapy after surgery. These therapies reduce the risk of cancer returning. Or you may receive chemotherapy if cancer has spread widely or youre not healthy enough for surgery. Your care team may suggest both treatments as part of your plan.

• #53 Ampullary Cancer Causes Symptoms Diagnosis Treatment

  https://www.medindia.net/health/conditions/ampullary-cancer.htm

  Ampullary cancer is a rare cancer arising from the ampulla of Vater, the anatomical structure that connects the common bile duct and pancreatic duct to the small intestine. […] The diagnosis of ampullary cancer is based on a combination of imaging tests and endoscopy with ultrasound and biopsy. […] A diagnosis of ampullary cancer typically requires radiographic imaging tests as well as endoscopy to obtain tissue biopsy. Blood tests can also aid in the diagnosis or determining if there are complications associated with the condition. […] Endoscopy can be used to directly visualize the cancer and obtain a biopsy sample.

• #54 Ampullary cancer | Health Library | Memorial Health System

  https://www.mhsystem.org/health-library/con-20213615/

  Ampullary cancer is cancer that starts as a growth of cells in the ampulla of Vater. […] Tests and procedures used to diagnose ampullary cancer include: […] Endoscopy is a procedure to examine the digestive system. […] Imaging tests make pictures of the body. They can show the location and size of ampullary cancer. […] A biopsy is a procedure to remove a sample of tissue for testing in a lab. The sample is tested in a lab to see if it is cancer. […] Ampullary cancer treatment often starts with surgery to remove the cancer. Other treatments may include chemotherapy and radiation. […] The best treatment for your ampullary cancer depends on several factors. These include the size of the cancer, your overall health and your preferences.

• #55 The Diagnosis and Treatment of Ampullary Carcinoma

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10714289/

  Ampullary carcinoma has an incidence of 0.5 to 0.9 per 100 000 persons and a poor prognosis, with a 5-year survival rate of 41% to 45% for locally confined and 4% to 7% for metastatic disease. […] The treatment of choice for ampullary carcinoma is radical oncological resection of the head of the pancreas with systematic lymphadenectomy. Five-year overall survival is between 10% and 75% depending on the stage. […] The current state of the evidence on the treatment of ampullary carcinoma is poor. […] The treatment of choice is resection by means of pylorus preserving resection of the head of the pancreas in the early stages and systemic therapy in irresectable tumors. […] The role of resection of metachronous metastases is not clear at this time and was studied by Saedon et al in a meta-analysis.

Zobacz więcej