Kwon CH, Seo HI, Kim DU, Han SY, Kim S, Lee NK, Hong SB, Ahn JH, Park YM, Noh BG. Survival benefit of concurrent chemoradiotherapy for advanced ampulla of Vater cancer. World J Clin Cases 2024; 12(2): 267-275 [PMID: 38313654 DOI: 10.12998/wjcc.v12.i2.267]
Corresponding Author of This Article
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
Research Domain of This Article
Oncology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Jan 16, 2024; 12(2): 267-275 Published online Jan 16, 2024. doi: 10.12998/wjcc.v12.i2.267
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 bya 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
ARTICLE HIGHLIGHTS
Research background
Although ampulla of Vater (AoV) cancer has a relatively favorable prognosis among periampullary cancers, the 5-yr survival rate after resection remains poor. The benefits of adjuvant treatment for AoV cancer is still controversial, leading to the prevalent use of chemotherapy or concurrent chemoradiotherapy (CCRT).
Research motivation
Despite clinical use of adjuvant treatment, there are no consensus guidelines for patients with AoV carcinoma. This study aims to contribute valuable insights into the survival benefits of CCRT in patients with advanced AoV cancer, providing evidence to guide treatment decisions.
Research objectives
The study aims to retrospectively assess the efficacy of adjuvant CCRT in patients with advanced AoV carcinoma who underwent curative resection.
Research methods
Eleven patients with advanced AoV cancer [T3/T4 or lymph node (LN) metastases] who underwent adjuvant CCRT, and 18 patients who did not receive adjuvant therapy were retrospectively reviewed.
Research results
The study found 1-, 3-, and 5-yr RFS rates of 82.8%, 48.3%, and 40.8%, and OS rates of 89.7%, 62.1%, and 51.7%, respectively, for advanced AoV cancer. T stage and LN metastasis were significantly associated with OS in the multivariate analysis. However, CCRT did not show a statistically significant survival advantage.
Research conclusions
This study suggests that adjuvant CCRT may not provide survival benefits for patients with advanced AoV cancer.
Research perspectives
Additional multi-institutional studies with larger sample sizes, standardized regimens, and histological evaluations are recommended to identify the optimal options for patients with advanced AoV cancer.
