Survival benefit of concurrent chemoradiotherapy for advanced ampulla of Vater cancer

Chae Hwa Kwon; Hyung Il Seo; Dong Uk Kim; Sung Yong Han; Suk Kim; Nam Kyung Lee; Seung Baek Hong; Ji Hyun Ahn; Young Mok Park; Byeong Gwan Noh

doi:10.12998/wjcc.v12.i2.267

Survival benefit of concurrent chemoradiotherapy for advanced ampulla of Vater cancer

World J Clin Cases. 2024 Jan 16;12(2):267-275. doi: 10.12998/wjcc.v12.i2.267.

Authors

Chae Hwa Kwon¹, Hyung Il Seo², Dong Uk Kim³, Sung Yong Han³, Suk Kim⁴, Nam Kyung Lee⁴, Seung Baek Hong⁴, Ji Hyun Ahn⁵, Young Mok Park⁶, Byeong Gwan Noh⁶

Affiliations

¹ BioMedical Research Institute, Pusan National University Hospital, Busan 49241, South Korea.
² Department of Surgery, Pusan National University School of Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan 49241, South Korea. seohi71@pusan.ac.kr.
³ Department of Internal Medicine, Pusan National University School of Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan 49241, South Korea.
⁴ Department of Radiology, Pusan National University School of Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan 49241, South Korea.
⁵ Department of Pathology and Biomedical Research Institute, Pusan National University Hospital, Busan 49241, South Korea.
⁶ Department of Surgery, Pusan National University School of Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan 49241, South Korea.

Abstract

Background: Currently, there is no standard adjuvant therapy for patients with resected ampulla of Vater (AoV) cancer.

Aim: To evaluate the effectiveness of adjuvant concurrent chemoradiotherapy (CCRT) in patients with advanced AoV cancer who underwent curative resection.

Methods: This single-centered, retrospective study included 29 patients with advanced AoV cancer who underwent pancreaticoduodenectomy between 2006 and 2018. The impact of CCRT on advanced AoV cancer was analyzed.

Results: The 1-, 3-, and 5-yr recurrence-free survival (RFS) rates for patients with advanced AoV cancer were 82.8%, 48.3%, and 40.8%, respectively, and the overall survival (OS) rates were 89.7%, 62.1%, and 51.7%, respectively. Lymphovascular invasion was found to be a significant risk factor for RFS and OS in patients with advanced AoV cancer in the univariate analysis, whereas T stage and lymph node metastasis were significantly associated with OS in the multivariate analysis. Compared to the patients who did not receive adjuvant CCRT, those who received adjuvant CCRT did not show statistically significant improvements in the RFS and OS, although they had a significantly lower average age and significantly higher platelet-to-lymphocyte ratio.

Conclusion: Adjuvant CCRT did not improve survival outcomes in patients with advanced AoV cancer. These findings contribute to existing knowledge on the effectiveness of CCRT in this patient population and provide important insights for clinical decision-making.

Keywords: Adjuvant concurrent chemoradiotherapy; Advanced ampulla of Vater cancer; Recurrence; Survival; Vater cancer.