Influence of Site of Origin and Mucin Production on Survival in Ampullary Carcinoma

We studied a series of 26 cases of carcinoma of the ampulla of Vater. There were 24 adenocarcinomas and two neuroendocrine tumors. Histologically the carcinomas could be divided into tumors arising from periampullary duodenal mucosa and those arising within the ampulla. True ampullary tumors had a significantly better 5-year survival rate (p = 0.028) than periampullary tumors. The type of mucin produced was investigated histochemically. Patients with true ampullary tumors producing predominantly sialomucins had a better prognosis than those with tumors secreting sulphated mucins (p = 0.045), but the numbers were small. We hypothesize that the most favorable type of ampullary carcinoma arises from biliary-type epithelium within the ampulla.