| Autor: |
Demirci NS; Department of Medical Oncology, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, 34098 Istanbul, Türkiye., Cavdar E; Department of Medical Oncology, Adiyaman Training and Research Hospital, Adiyaman University, 02000 Adiyaman, Türkiye., Ozdemir NY; Department of Medical Oncology, Faculty of Medicine, Yıldırım Beyazıt University, 06010 Ankara, Türkiye., Yuksel S; Department of Medical Oncology, Dr. Lutfi Kirdar Kartal Education and Research Hospital, 34865 Istanbul, Türkiye., Iriagac Y; Department of Medical Oncology, Balikesir Ataturk City Hospital, 10100 Balikesir, Türkiye., Erdem GU; Department of Medical Oncology, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, 34098 Istanbul, Türkiye., Odabas H; Department of Medical Oncology, Dr. Lutfi Kirdar Kartal Education and Research Hospital, 34865 Istanbul, Türkiye., Hacibekiroglu I; Department of Medical Oncology, Faculty of Medicine, Sakarya University, 54050 Sakarya, Türkiye., Karaagac M; Department of Medical Oncology, Meram Medical Faculty, Necmettin Erbakan University, 42090 Konya, Türkiye., Ucar M; Department of Medical Oncology, Faculty of Medicine, Erciyes University, 38039 Kayseri, Türkiye., Ozturk B; Department of Medical Oncology, Akdeniz University, 07058 Antalya, Türkiye., Bozkaya Y; Department of Medical Oncology, Yeniyuzyil University-Gaziosmanpasa Hospital, 34098 Istanbul, Türkiye. |
| Abstrakt: |
Background and Objectives: In ampullary cancer, 5-year survival rates are 30-50%, even with optimal resection and perioperative systemic therapies. We sought to determine the important clinicopathological features and adjuvant treatments in terms of the prognosis of patients with operable-stage ampullary carcinomas. Materials and Methods: We included 197 patients who underwent pancreaticoduodenectomy to treat ampullary carcinomas between December 2003 and May 2019. Demographics, clinical features, treatments, and outcomes/survival were analyzed. Results: The median disease-free survival (mDFS) and median overall survival (mOS) were 40.9 vs. 63.4 months, respectively. The mDFS was significantly lower in patients with lymphovascular invasion ( p < 0.001) and lymph node involvement ( p = 0.027). Potential predictors of decreased OS on univariate analysis included age ≥ 50 years ( p = 0.045), poor performance status ( p = 0.048), weight loss ( p = 0.045), T3-T4 tumors ( p = 0.018), surgical margin positivity ( p = 0.01), lymph node involvement ( p = 0.001), lymphovascular invasion ( p < 0.001), perineural invasion ( p = 0.007), and poor histological grade ( p = 0.042). For the multivariate analysis, only nodal status (hazard ratio [HR]1.98; 95% confidence interval [CI], 1.08-3.65; p = 0.027) and surgical margin status (HR 2.61; 95% CI, 1.09-6.24; p = 0.03) were associated with OS. Conclusions: Nodal status and a positive surgical margin were independent predictors of a poor mOS for patients with ampullary carcinomas. Additional studies are required to explore the role of adjuvant therapy in patients with ampullary carcinomas. |
