Predictors of Long-Term Survival Following Resection for Ampullary Carcinoma

Autor: Antoine Hamy, Aude Merdrignac, Pierre-Emmanuel Robert, Christophe Leux, Fabrice Muscari, Brice Gayet, Lilian Schwarz, François Paye, Jean Robert Delpero, Mathieu Miguet, Nicolas Carrere, N. Regenet, David Dussart, Mehdi Ouaissi
Rok vydání: 2014
Předmět:
Male
Pathology
Time Factors
Endocrinology
Diabetes and Metabolism
Kaplan-Meier Estimate
030230 surgery
0302 clinical medicine
Endocrinology
Outcome Assessment
Health Care
Neoplasm
Aged
80 and over
Ampullary carcinoma
Ampulla of Vater
Middle Aged
Prognosis
Combined Modality Therapy
3. Good health
Rare tumor
medicine.anatomical_structure
Chemotherapy
Adjuvant
Lymphatic Metastasis
030220 oncology & carcinogenesis
Female
France
Radiology
Adult
medicine.medical_specialty
Common Bile Duct Neoplasms
digestive system
Disease-Free Survival
Resection
03 medical and health sciences
Long term survival
Internal Medicine
medicine
Carcinoma
Humans
Aged
Neoplasm Staging
Proportional Hazards Models
Retrospective Studies
Hepatology
business.industry
medicine.disease
digestive system diseases
Pancreatic Neoplasms
Multivariate Analysis
Neoplasm Recurrence
Local
business
Follow-Up Studies
Zdroj: Pancreas. 43:692-697
ISSN: 0885-3177
Popis: Ampullary carcinoma is a rare tumor. There are neither sufficient available data related to management after resection of the neoplasm of the ampulla of Vater, nor any international recommendations. The aim of this study was to identify factors associated with recurrence and survival after curative resection.A retrospective follow-up study was conducted including patients with ampullary carcinoma who underwent resection with curative intent in 12 French surgical centers between January 1990 and November 2011.In this study, 319 patients underwent surgical resection for an ampullary neoplasm. Disease recurred in 120 patients (37.6%), and the 5- and 10-year disease-free survival rates were 48.9% and 40.4%, respectively. In multivariable Cox regression, preoperative bilirubin, T stage, pancreaticobiliary histology subtype, and lymph node involvement were each significantly associated with the risk of recurrence.Ampullary carcinomas are a heterogeneous group that can be classified as intestinal and pancreaticobiliary subtypes. Our findings indicate that pancreaticobiliary differentiation, advanced stage, and lymph node involvement are predictors of both poor disease-free and poor overall survival. It is still unclear what adjuvant treatment after curative resection of ampullary carcinoma is optimal. It would be informative to evaluate adjuvant therapy according to histological subtype.
Databáze: OpenAIRE
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