In:
Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 33, No. 3_suppl ( 2015-01-20), p. 415-415
Abstract:
415 Background: Ampulla of Vater cancer (AoV ca) is rare tumor, and its adjuvant treatment after curative resection has not been well established. The purpose of this study is to see the clinical outcomes of curatively resected AoV ca patients and to figure out the role of adjuvant treatment. Methods: We reviewed 227 AoV ca patients who underwent curative resection at the Seoul National University Hospital between 1997 and 2012. Clinical factors, pathologic findings, adjuvant treatment pattern, disease-free survival (DFS) and overall survival (OS) were analyzed. Results: Median age was 61.5 year old (range, 33.8-88.2) and 125 patients were male. T1/T2 stage was found in 63.9% of patients and T3/4 stage was in 36.1%. Seventy-seven patients (33.9%) had node positive disease (N+) and seventy-three patients (32.1%) had well-differentiated histology. OS of all patients was 90.9 months (95% CI: 58.4-128.09). 5-Year OS- and DFS- rate were 58.2% and 62.5%, respectively. On multivariate analysis, adverse prognostic factors for OS included poorly differentiated histology (HR 1.35, 95% CI: 1.01-1.81, p=0.045), elevated CEA (HR 2.55, 95% CI: 1.29-5.04, p=0.007), elevated CA 19-9(HR 1.86, 95% CI: 1.08-3.21, p=0.027), and stage (HR 2.34, 95% CI: 1.43-3.82, p=0.001). A total of 104 patients (46.3%) received adjuvant treatment (concurrent chemoradiotherapy (CCRT) 32, CCRT with maintenance chemotherapy 58, chemotherapy alone 9, radiotherapy alone 5). Most of the chemotherapies were 5-FU-based ones. Among patients with T1/T2 & N (-) (n=111), only 25 patients (22.5%) received adjuvant treatment. In contrast, among patients with T3/T4 or N (+) (n=116), 79 patients (68.1%) received adjuvant treatment. 5Y-OS rate was 74.1% in patients with T1/T2 and N (-) and that of patients with T3/T4 or N (+) was 43.0% (p 〈 0.001). In T1/T2 and N (-) stage, OS was not different according to adjuvant treatment. In T3/T4 or N (+) stage, adjuvant CCRT with maintenance chemotherapy conferred the longest OS, which was not statistically significant. (5Y-OSR: 47.0% vs 41.4% in no adjuvant treatment.) Conclusions: Adjuvant treatment should be further defined in AoV ca, especially in T3/T4 or N (+) stage.
Type of Medium:
Online Resource
ISSN:
0732-183X
,
1527-7755
DOI:
10.1200/jco.2015.33.3_suppl.415
Language:
English
Publisher:
American Society of Clinical Oncology (ASCO)
Publication Date:
2015
detail.hit.zdb_id:
2005181-5
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