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- Title
Adjuvant Chemotherapy for Resected Ampulla of Vater Carcinoma: Retrospective Analysis of 646 Patients.
- Authors
Jwa Hoon Kim; Jae Ho Jeong; Baek-Yeol Ryoo; Kyu-pyo Kim; Heung-Moon Chang; Dongwook Oh; Tae Jun Song; Sang Soo Lee; Dong Wan Seo; Sung Koo Lee; Myung-Hwan Kim; Yejong Park; Jae Woo Kwon; Dae Wook Hwang; Jae Hoon Lee; Woohyung Lee; Song Cheol Kim; Changhoon Yoo; Ki Byung Song
- 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 recurrencefree 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.
- Subjects
ADJUVANT chemotherapy; PROPENSITY score matching; PROGNOSIS; RETROSPECTIVE studies; CARCINOMA
- Publication
Cancer Research & Treatment, 2021, Vol 53, Issue 2, p424
- ISSN
1598-2998
- Publication type
Article
- DOI
10.4143/crt.2020.953