Pancreaticoduodenectomy (PD) is the standard curative treatment for periampullary tumors. The aim of this study is to report the incidence and predictors of long-term survival (≥?5 years) after PD.

This study included patients who underwent PD for pathologically proven periampullary adenocarcinomas. Patients were divided into 2 groups: group (I) patients who survived less than 5 years and group (II) patients who survived?≥?5 years.

There were 47 (20.6%) long-term survivors (≥?5 years) among 228 patients underwent PD for periampullary adenocarcinoma. Patients with ampullary adenocarcinoma represented 31 (66.0%) of the long-term survivors. Primary analysis showed that favourable factors for long-term survival include age?<?60 years old, serum CEA?<?5?ng/mL, serum CA 19-9?<?37?U/mL, non-cirrhotic liver, tumor size?<?2?cm, site of primary tumor, postoperative pancreatic fistula, R0 resection, postoperative chemotherapy, and no recurrence. Multivariate analysis demonstrated that CA 19-9?<?37?U/mL [OR (95% CI)?=?1.712 (1.248-2.348), P?=?0.001], smaller tumor size [OR (95% CI?)=?1.335 (1.032-1.726), P?=?0.028] and Ro resection [OR (95% CI)?=?3.098 (2.095-4.582), P?<?0.001] were independent factors for survival?≥?5 years. The prognosis was best for ampullary adenocarcinoma, for which the median survival was 54 months and 5-year survival rate was 39.0%, and the poorest was pancreatic head adenocarcinoma, for which the median survival was 27 months and 5-year survival rate was 7%.

The majority of long-term survivors after PD for periampullary adenocarcinoma are patients with ampullary tumor. CA 19-9?<?37?U/mL, smaller tumor size, and R0 resection were found to be independent factors for long-term survival?≥?5 years.