Radiation Oncology/Ampulla
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Ampulla of Vater
Background
- Must be distinguished from other periampullary tumors, including tumors arising in the pancreatic head and the distal common bile duct.
- Primary tumors of the ampulla are uncommon (15-25% of periampullary tumors). However, tumors of the ampulla of Vater make up a large percentage of duodenal tumors.
Staging
AJCC 7th Edition (2009)
Primary Tumor:
- Tis - carcinoma in situ
- T1 - limited to ampulla of Vater or sphincter of Oddi
- T2 - invades duodenal wall
- T3 - invades pancreas
- T4 - invades peripancreatic soft tissues or other adjacent organs or structures
Regional Lymph Nodes:
- N0 - none
- N1 - yes
- Regional nodes: peripancreatic, including lymph nodes along hepatic artery and portal vein
Distant Metastases:
- M0 - none
- M1 - yes
Stage Grouping:
- IA - T1 N0
- IB - T2 N0
- IIA - T3 N0
- IIB - T1-3 N1
- III - T4
- IV - M1
Older staging systems
AJCC 6th Edition (2002)
No changes compared to 7th edition
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