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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