Management and outcomes following pancreaticoduodenectomy for ampullary adenocarcinoma.
Am J Surg. 2017 Jan 30;:
Authors: Chavez MT, Sharpe JP, O'Brien T, Patton KT, Portnoy DC, VanderWalde NA, Deneve JL, Shibata D, Behrman SW, Dickson PV
INTRODUCTION: The purpose of this study was to evaluate outcomes following pancreaticoduodenectomy(PD) for ampullary adenocarcinoma(AAC).
METHODS: We evaluated patients having undergone PD for AAC and the impact of clinical/histopathologic factors and adjuvant therapy(AT) on survival.
RESULTS: 52 patients underwent potentially curative PD. Perineural and lymphovascular invasion were associated with decreased survival. There was no difference in survival between patients treated with PD vs. PD+AT, however, AT was more often administered to patients with N1 vs. N0 and stage II/III vs. I disease. Among patients receiving AT, we observed a trend towards improved survival when radiation was included. Recurrence occurred in 7/18(39%) stage I patients, only 2(7%) of which received AT.
CONCLUSION: AT did not improve survival, however was more commonly administered in advanced disease. Stage I patients had high recurrence rates but rarely received AT. Prospective evaluation of appropriate AT regimens and use in early stage patients should be considered.
PMID: 28285709 [PubMed - as supplied by publisher]