Oncologic outcomes in resected ampullary cancer: Relevance of histologic subtype and adjuvant chemotherapy - 20/05/21
Abstract |
Background |
Outcomes in ampullary cancer (AC) may differ by pathologic subtype. No guidelines exist for the administration of adjuvant therapy (AT). We sought to evaluate the effect of subtype and AT on survival.
Methods |
An institutional review of patients undergoing resection for AC from 2008-17 was performed. Recurrence-free (RFS) and overall survival (OS) were assessed by Kaplan-Meier and Cox proportional hazards modeling.
Results |
Of 53 patients, two-thirds (62%) were stage III. Histologic subtype was evenly split between intestinal and pancreatobiliary (43% and 40%). Half of patients received AT. RFS and OS were 25 (95% CI 16–32) and 41 (CI 22–60) months, respectively, without significant difference by subtype. Stage II/III disease was associated with worse OS (HR 3.7, P = 0.03), which was improved with receipt of AT (HR 0.44, P < 0.05).
Conclusion |
Stage is the primary determinant of survival in AC, which may be improved with AT.
Le texte complet de cet article est disponible en PDF.Highlights |
• | No consensus guidelines for peri-operative therapy for resectable ampullary cancer. |
• | Systemic therapy advisable for T3 and node-positive ampullary cancer. |
• | Chemoradiation may be warranted given risk of locoregional recurrence. |
• | Neoadjuvant therapy should be considered given challenging completion of adjuvant. |
Keywords : Ampullary cancer, Hepatopancreatobiliary surgery, Pancreatoduodenectomy, Cancer outcomes, Adjuvant therapy
Plan
Vol 221 - N° 6
P. 1128-1134 - juin 2021 Retour au numéro
Article précédent
- Outcomes in resected ampullary cancer: Difficult decision-making in an uncommon heterogeneous malignancy
- Lloyd A. Mack
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