Effect of the DNA ploidity on survival in patients with carcinoma of papilla of Vater.

The authors investigated the possible prognostic factors for survival after pancreaticoduodenectomy for carcinoma of papilla of Vater. From 1984 to 1995, 8 patients underwent radical surgical intervention for tumor of papilla of Vater. The mean age of the patients was 58 years. Three of them were over 60 years. In one case Whipple procedure was performed, and pylorus-preserving pancreaticoduodenectomy was carried out in 7 patients. Using flow cytometry, the authors measured the nuclear DNA content of tumor cells. DNA ploidity status was evaluated from paraffin-embedded tumor tissues. Perioperative mortality occurred in one patient. Reoperation was performed on 2 patients, because of presence of anastomotic leakage. Survival was 50% at 1 year, 37.5% at 3 years, and 25% at 5 years. Tumor size (> 2 cm) was not negative prognostic factors for survival. The mean survival of patients with diploid cancer (n:6) was 17 months, and the mean survival of patients with aneuploid carcinoma (n:2) was 56 months. The proliferative index of the diploid carcinomas ranged from 3% to 11%. The proliferative index of the aneuploid tumors ranged from 17% to 28%. In conclusion, tumor size (> 2 cm), DNA ploidity status and proliferative index were not significantly negative prognostic factors for survival in patients with tumor of papilla of Vater.