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. 2017 Nov;214(5):856-861.
doi: 10.1016/j.amjsurg.2017.01.029. Epub 2017 Jan 30.

Management and outcomes following pancreaticoduodenectomy for ampullary adenocarcinoma

M T Chavez  1 , J P Sharpe  1 , T O'Brien  2 , K T Patton  3 , D C Portnoy  4 , N A VanderWalde  5 , J L Deneve  1 , D Shibata  1 , S W Behrman  1 , P V Dickson  6
Affiliations

Management and outcomes following pancreaticoduodenectomy for ampullary adenocarcinoma

M T Chavez et al. Am J Surg. 2017 Nov.

Abstract

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.

Keywords: Adjuvant therapy; Ampullary adenocarcinoma; Pancreaticoduodenectomy; Prognosis.

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