Management and outcomes following pancreaticoduodenectomy for ampullary adenocarcinoma.

Autor: Chavez MT; Department of Surgery, Division of Surgical Oncology, University of Tennessee Health Science Center, Memphis, TN, USA., Sharpe JP; Department of Surgery, Division of Surgical Oncology, University of Tennessee Health Science Center, Memphis, TN, USA., O'Brien T; Memphis Pathology Group, Memphis, TN, USA., Patton KT; Pathology Group of the Midsouth, Germantown, TN, USA., Portnoy DC; Division of Hematology/Oncology, University of Tennessee Health Science Center and West Cancer Center, Memphis, TN, USA., VanderWalde NA; Department of Radiation Oncology, University of Tennessee Health Science Center and West Cancer Center, Memphis, TN, USA., Deneve JL; Department of Surgery, Division of Surgical Oncology, University of Tennessee Health Science Center, Memphis, TN, USA., Shibata D; Department of Surgery, Division of Surgical Oncology, University of Tennessee Health Science Center, Memphis, TN, USA., Behrman SW; Department of Surgery, Division of Surgical Oncology, University of Tennessee Health Science Center, Memphis, TN, USA., Dickson PV; Department of Surgery, Division of Surgical Oncology, University of Tennessee Health Science Center, Memphis, TN, USA. Electronic address: pdickso1@uthsc.edu.
Jazyk: angličtina
Zdroj: American journal of surgery [Am J Surg] 2017 Nov; Vol. 214 (5), pp. 856-861. Date of Electronic Publication: 2017 Jan 30.
DOI: 10.1016/j.amjsurg.2017.01.029
Abstrakt: 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.
(Copyright © 2017 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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