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Does adjuvant treatment improve prognosis after curative resection of ampulla of Vater carcinoma? A multicenter retrospective study
Author(s) -
Kim Hyung Sun,
Jang JinYoung,
Yoon YooSeok,
Park SangJae,
Kwon Wooil,
Kim SunWhe,
Han Ho Seong,
Han SungSik,
Park Joon Seong,
Yoon Dong Sup
Publication year - 2020
Publication title -
journal of hepato‐biliary‐pancreatic sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 1868-6974
DOI - 10.1002/jhbp.801
Subject(s) - medicine , adjuvant , stage (stratigraphy) , adjuvant therapy , single center , oncology , retrospective cohort study , ampulla of vater , carcinoma , gastroenterology , surgery , cancer , paleontology , biology
Background/Purpose Ampulla of Vater (AoV) carcinoma is a rare tumor that accounts for approximately 0.2% of gastrointestinal malignancies. There are no clinical guidelines concerning the treatment of AoV carcinoma. This study aimed to investigate the effectiveness of adjuvant treatment in AoV carcinoma following curative resection and define the “high‐risk” group. Methods Clinical data of patients who underwent curative resection for AoV carcinoma in four hospitals, namely Yonsei Gangnam Severance Hospital, Seoul National University Hospital, Seoul National University Bundang Hospital, and National Cancer Center (n = 651; 2002–2015), were reviewed. Overall survival (OS) and recurrence‐free survival (RFS) rates were compared using Kaplan–Meier estimates. Results Data of 651 patients who had undergone curative resection were retrospectively reviewed. Age, T stage, N stage, and differentiation type remained strong and independent risk factors for RFS and OS. In early‐stage AoV carcinoma (T1N0, T2N0), the non‐adjuvant group had better prognosis based on the RFS and OS than the adjuvant group ( P < .001, P = .007). In advanced T stage (T3N0, T4N0), the adjuvant group had better prognosis than the non‐adjuvant group, but the difference was not statistically significant ( P > .05). In node‐positive patients (any T, N1/2), adjuvant treatment did not affect RFS and OS ( P > .05). Conclusions Adjuvant treatment after curative resection of AoV carcinoma is not associated with improved survival. The high‐risk group (node‐positive or advanced T stage (T3, T4)) treated with adjuvant treatment was not statistically associated with improved survival; however, our study showed that the adjuvant treatment for the high‐risk group might help achieve better patient outcome.