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©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
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
Chae Hwa Kwon, BioMedical Research Institute, Pusan National University Hospital, Busan 49241, South Korea
Hyung Il Seo, Young Mok Park, Byeong Gwan Noh, Department of Surgery, Pusan National University School of Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan 49241, South Korea
Dong Uk Kim, Sung Yong Han, Department of Internal Medicine, Pusan National University School of Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan 49241, South Korea
Suk Kim, Nam Kyung Lee, Seung Baek Hong, Department of Radiology, Pusan National University School of Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan 49241, South Korea
Ji Hyun Ahn, Department of Pathology and Biomedical Research Institute, Pusan National University Hospital, Busan 49241, South Korea
Author contributions: Seo HI contributed design of the study; Kwon CH contributed analysis of data; Seo HI and Kwon CH contributed interpretation of data and drafting the article; Kim DU and Han SY contributed review the manuscript; Kim S, Lee NK, Hong SB, Ahn JH, Par YM and Noh BG contributed acquisition of data; all authors have read and approved the final manuscript.
Supported by a Biomedical Research Institute Grant (202300060001) from Pusan National University Hospital.
Institutional review board statement: This study was approved by the Institutional Review Board of Clinical Trial Center in Pusan National University hospital (IRB No. 2303-007-124).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors have no financial relationships to disclose.
Data sharing statement: The data that support the findings of this study are available from the corresponding author.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Hyung Il Seo, MD, PhD, Surgeon, Department of Surgery, Pusan National University School of Medicine and Biomedical Research Institute, Pusan National University Hospital, 179, Gudeok-ro, Seo-gu, Busan 49241, South Korea.
seohi71@pusan.ac.kr
Received: October 31, 2023
Peer-review started: October 31, 2023
First decision: November 28, 2023
Revised: December 7, 2023
Accepted: December 27, 2023
Article in press: December 27, 2023
Published online: January 16, 2024
Processing time: 71 Days and 22.8 Hours
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.
Core Tip: We examined the potential survival benefits of adjuvant concurrent chemoradiotherapy (CCRT). Our findings indicated that adjuvant CCRT may not provide any survival advantage to patients with ampulla of Vater (AoV) cancer who had T3/T4 or lymph node-positive tumors. Therefore, the use of adjuvant CCRT as a standard approach in the treatment of advanced AoV cancer patients should be reconsidered.
