PURPOSE: To determine the effects of adjuvant radiotherapy and chemotherapy for carcinoma of the ampulla of Vater. METHODS AND MATERIALS: We retrospectively reviewed the records of 125 patients who underwent definitive surgery for carcinomas involving the ampulla of Vater between April 1977 and February 2005 and who survived more than 50 days after surgery. Twenty-nine of the patients also received adjuvant radiotherapy (median dose, 50.4 Gy in 28 fractions) with concurrent 5-fluorouracil chemotherapy. Adverse prognostic factors were investigated, and overall survival (OS) and local and distant failure were estimated. RESULTS: Adverse prognostic factors for decreased OS by univariate analysis included lymph node (LN) involvement, locally advanced tumors (T3/T4), and poor histologic grade. By multivariate analysis, positive LN status (p=0.02) alone was associated with decreased OS. The addition of adjuvant radiotherapy and chemotherapy improved OS for patients with positive LN (p=0.01). Median survival for positive LN patients receiving adjuvant therapy was 3.4 years, vs. 1.6 years for those with surgery alone. CONCLUSIONS: The addition of adjuvant radiotherapy and 5-fluorouracil chemotherapy may improve OS in patients with LN involvement. The effect of adjuvant therapy on outcomes for patients with poor histologic grade or T3/T4 tumors without LN involvement could not be assessed.
PURPOSE: To determine the effects of adjuvant radiotherapy and chemotherapy for carcinoma of the ampulla of Vater. METHODS AND MATERIALS: We retrospectively reviewed the records of 125 patients who underwent definitive surgery for carcinomas involving the ampulla of Vater between April 1977 and February 2005 and who survived more than 50 days after surgery. Twenty-nine of the patients also received adjuvant radiotherapy (median dose, 50.4 Gy in 28 fractions) with concurrent 5-fluorouracil chemotherapy. Adverse prognostic factors were investigated, and overall survival (OS) and local and distant failure were estimated. RESULTS: Adverse prognostic factors for decreased OS by univariate analysis included lymph node (LN) involvement, locally advanced tumors (T3/T4), and poor histologic grade. By multivariate analysis, positive LN status (p=0.02) alone was associated with decreased OS. The addition of adjuvant radiotherapy and chemotherapy improved OS for patients with positive LN (p=0.01). Median survival for positive LN patients receiving adjuvant therapy was 3.4 years, vs. 1.6 years for those with surgery alone. CONCLUSIONS: The addition of adjuvant radiotherapy and 5-fluorouracil chemotherapy may improve OS in patients with LN involvement. The effect of adjuvant therapy on outcomes for patients with poor histologic grade or T3/T4 tumors without LN involvement could not be assessed.
Authors: Michelle D Reid; Serdar Balci; Nobuyuki Ohike; Yue Xue; Grace E Kim; Takuma Tajiri; Bahar Memis; Ipek Coban; Anil Dolgun; Alyssa M Krasinskas; Olca Basturk; David A Kooby; Juan M Sarmiento; Shishir K Maithel; Bassel F El-Rayes; Volkan Adsay Journal: Mod Pathol Date: 2016-09-02 Impact factor: 7.842
Authors: Ibrahim Nassour; Linda S Hynan; Alana Christie; Rebecca M Minter; Adam C Yopp; Michael A Choti; John C Mansour; Matthew R Porembka; Sam C Wang Journal: J Gastrointest Surg Date: 2017-11-10 Impact factor: 3.452
Authors: Matthew P Doepker; Zachary J Thompson; Barbara A Centeno; Richard D Kim; Joyce Wong; Pamela J Hodul Journal: J Surg Oncol Date: 2016-05-09 Impact factor: 3.454
Authors: Jim Zhong; Manisha Palta; Christopher G Willett; Shannon J McCall; Frances McSherry; Douglas S Tyler; Hope E Uronis; Brian G Czito Journal: J Gastrointest Oncol Date: 2014-12
Authors: Manisha Palta; Pretesh Patel; Gloria Broadwater; Christopher Willett; Joseph Pepek; Douglas Tyler; S Yousuf Zafar; Hope Uronis; Herbert Hurwitz; Rebekah White; Brian Czito Journal: Ann Surg Oncol Date: 2011-11-02 Impact factor: 5.344
Authors: Adriana Romiti; Viola Barucca; Angelo Zullo; Ida Sarcina; Roberta Di Rocco; Chiara D'Antonio; Marco Latorre; Paolo Marchetti Journal: World J Gastrointest Oncol Date: 2012-03-15