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Adjuvant Chemotherapy for Resected Ampulla of Vater Carcinoma: Retrospective Analysis of 646 Patients

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Abstract
Purpose This study evaluated the efficacy of adjuvant chemotherapy (AC) in patients with resected ampulla of Vater (AoV) carcinoma.

Materials and Methods Data from 646 patients who underwent surgical resection at Asan Medical Center between 2000 and 2017 were retrospectively reviewed.

Results The median age of the patients was 62 years, and 54.2% were male. Patients were classified into AC group (n=165, 25.5%) and no AC group (n=481, 74.5%). With a median follow-up duration of 88 months, in patients with stage I, II, III, median recurrence free survival (RFS) was not reached, 44 months, and 15 months, respectively, and the median overall survival (OS) were not reached, 88 months and 35 months, respectively. Despite no statistical significance, RFS and OS were better in stage II patients with AC than in those without AC (median RFS, 151 months vs. 38 months; p=0.156 and median OS, 153 months vs. 74 months; p=0.299). In multivariate analysis for RFS and OS, TNM stage, R1 resection status, presence of lymphovascular invasion, and perineural invasion remained significant factors, whereas AC (hazard ratio [HR], 0.74; 95% confidence interval [CI], 0.54 to 1.00; p=0.052) was marginally related with RFS. After propensity score matching in only stage II/III patients, RFS and OS with AC were numerically longer than those without AC (HR, 0.80; 95% CI, 0.60 to 1.06; p=0.116 and HR, 0.77; 95% CI, 0.56 to 1.06; p=0.111).

Conclusion AC with fluoropyrimidine did not improve survival of patients with resected AoV carcinoma. However, multivariate analysis with prognostic factors showed a marginally significant survival benefit with AC.
Author(s)
권재우김규표김명환김송철김좌훈류백렬박예종서동완송기병송태준오동욱유창훈이상수이성구이우형이재훈장흥문정재호황대욱
Issued Date
2021
Type
Article
Keyword
Ampulla of Vater carcinomaAdjuvant chemotherapyFluoropyrimidineSurvival
DOI
10.4143/crt.2020.953
URI
https://oak.ulsan.ac.kr/handle/2021.oak/7958
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_nrf_kci_oai_kci_go_kr_ARTI_9774550&context=PC&vid=ULSAN&lang=ko_KR&search_scope=default_scope&adaptor=primo_central_multiple_fe&tab=default_tab&query=any,contains,Adjuvant%20Chemotherapy%20for%20Resected%20Ampulla%20of%20Vater%20Carcinoma:%20Retrospective%20Analysis%20of%20646%20Patients&offset=0&pcAvailability=true
Publisher
CANCER RESEARCH AND TREATMENT
Location
대한민국
Language
영어
ISSN
1598-2998
Citation Volume
53
Citation Number
2
Citation Start Page
424
Citation End Page
435
Appears in Collections:
Medicine > Medicine
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