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KMID : 0939920210530020424
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대한암학회지
2021 Volume.53 No. 2 p.424 ~ p.435
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Adjuvant Chemotherapy for Resected Ampulla of Vater Carcinoma: Retrospective Analysis of 646 Patients
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Kim Jwa-Hoon
Jeong Jae-Ho
Ryoo Baek-Yeol
Kim Kyu-Pyo
Chang Heung-Moon
Oh Dong-Wook
Song Tae-Jun
Lee Sang-Soo
Seo Dong-Wan
Lee Sung-Koo
Kim Myung-Hwan
Park Ye-Jong
Kwon Jae-Woo
Hwang Dae-Wook
Lee Jae-Hoon
Lee Woo-Hyung
Kim Song-Cheol
Yoo Chang-Hoon
Song Ki-Byung
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Abstract
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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.
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KEYWORD
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Ampulla of Vater carcinoma, Adjuvant chemotherapy, Fluoropyrimidine, Survival
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