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

Cancer Research and Treatment 2021년 53권 2호 p.424 ~ 435
김좌훈, 정재호, 류백열, 김규표, 장흥문, 오동욱, 송태준, 이상수, 서동완, 이승구, 김명환, 박예종, 권재우, 황대욱, 이재훈, 이우형, 김송철, 유창훈, 송기병,
소속 상세정보
김좌훈 ( Kim Jwa-Hoon ) - University of Ulsan College of Medicine Asan Medical Center Department of Oncology
정재호 ( Jeong Jae-Ho ) - University of Ulsan College of Medicine Asan Medical Center Department of Oncology
류백열 ( Ryoo Baek-Yeol ) - University of Ulsan College of Medicine Asan Medical Center Department of Oncology
김규표 ( Kim Kyu-Pyo ) - University of Ulsan College of Medicine Asan Medical Center Department of Oncology
장흥문 ( Chang Heung-Moon ) - University of Ulsan College of Medicine Asan Medical Center Department of Oncology
오동욱 ( Oh Dong-Wook ) - University of Ulsan College of Medicine Asan Medical Center Department of Gastroenterology
송태준 ( Song Tae-Jun ) - University of Ulsan College of Medicine Asan Medical Center Department of Gastroenterology
이상수 ( Lee Sang-Soo ) - University of Ulsan College of Medicine Asan Medical Center Department of Gastroenterology
서동완 ( Seo Dong-Wan ) - University of Ulsan College of Medicine Asan Medical Center Department of Gastroenterology
이승구 ( Lee Sung-Koo ) - University of Ulsan College of Medicine Asan Medical Center Department of Gastroenterology
김명환 ( Kim Myung-Hwan ) - University of Ulsan College of Medicine Asan Medical Center Department of Gastroenterology
박예종 ( Park Ye-Jong ) - University of Ulsan College of Medicine Asan Medical Center Department of Surgery
권재우 ( Kwon Jae-Woo ) - University of Ulsan College of Medicine Asan Medical Center Department of Surgery
황대욱 ( Hwang Dae-Wook ) - University of Ulsan College of Medicine Asan Medical Center Department of Surgery
이재훈 ( Lee Jae-Hoon ) - University of Ulsan College of Medicine Asan Medical Center Department of Surgery
이우형 ( Lee Woo-Hyung ) - University of Ulsan College of Medicine Asan Medical Center Department of Surgery
김송철 ( Kim Song-Cheol ) - University of Ulsan College of Medicine Asan Medical Center Department of Surgery
유창훈 ( Yoo Chang-Hoon ) - University of Ulsan College of Medicine Asan Medical Center Department of Oncology
송기병 ( Song Ki-Byung ) - University of Ulsan College of Medicine Asan Medical Center Department of Surgery

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.

키워드

Ampulla of Vater carcinoma; Adjuvant chemotherapy; Fluoropyrimidine; Survival

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