Surgical management and histopathological patterns of periampullary cancers in Sudanese patients: A single-center prospective study

Abstract

Background

Histopathological patterns of periampullary cancers (PAC) provide valuable information for clinicians in the selection of effective postoperative therapies and serve as a prognostic marker for patients. Therefore, this study was conducted to determine the surgical management and histopathological patterns of PAC necessary to achieve excellent surgical outcomes.

Methods

This prospective study was conducted from October 2021 to September 2023 at Ibn Sina Specialized Hospital, Khartoum, Sudan. Eighty patients diagnosed with resectable PAC were enrolled.

Results

PAC was more prevalent in male patients (52.5%), with a male: female ratio of 1.1:1.0. The peak incidence occurred between 46 and 60 years, representing 38.75% of patients. The most significant reported comorbidity was cigarette smoking (36.25% of patients). Scleral icterus was found in 47.5% of patients. Pancreatic head cancer was found in 55% of patients. Histopathological analysis revealed adenocarcinoma in 82.5% of patients. R0 resection (tumor-free margins) was the most common resection category (87.5% of patients). Lymphovascular invasion was detected in 37.5% of patients. Malignant lymph node involvement (1–3 nodes) was found 47.5% of patients. Perineural invasion was found in 55%. Finally, the most common histopathological differentiation of PAC was well-differentiated (Grade I) in 67.5% of patients. The mortality rate was 0%.

Conclusions

Updated knowledge regarding the management modalities of PAC is a prerequisite for accurate histopathological assessment and good surgical outcomes. Furthermore, histopathological analysis helps clinicians to select effective postoperative therapies for greater improvement in survival outcomes.