Survival benefit of concurrent chemoradiotherapy for advanced ampulla of Vater cancer

doi:10.12998/wjcc.v12.i2.267

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Jan 16, 2024 (publication date) through Feb 14, 2025

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World Journal of Clinical Cases

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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

Table 1 Univariate and multivariate analyses for recurrence-free survival

	Univariate		Multivariate
	HR (95%CI)	P value	HR (95%CI)	P value
Sex (male)	1.988 (0.568-6.955)	0.282
Age	0.976 (0.939-1.014)	0.215
Size	0.816 (0.530-1.255)	0.354
T stage	1.808 (0.485-6.743)	0.378	1.952 (0.499-7.628)	0.326
LN metastasis (positive)	2.026 (0.747-5.498)	0.166	1.848 (0.522-6.541)	0.341
LVI (positive)	2.971 (1.123-7.861)	0.028^a	2.002 (0.589-6.806)	0.266
PNI (positive)	1.026 (0.395-2.663)	0.958
Differentiation (poor)	1.366 (0.504-3.706)	0.540
CCRT	1.543 (0.594-4.006)	0.373
Bilirubin	0.935 (0.864-1.01)	0.089
CEA (≥ 5 ng/mL)	0.429 (0.056-3.288)	0.416
CA19.9 (≥ 39 U/L)	0.635 (0.225-1.796)	0.392
CRP (≥ 0.5 mg/mL)	1.139 (0.367-3.536)	0.822
Albumin (< 3.3 or > 5.2 mg/dL)	0.903 (0.119-6.831)	0.922
PLR	1.001 (0.997-1.005)	0.661
NLR	0.999 (0.871-1.144)	0.983

^aP < 0.05.

LN: Lymph node; LVI: Lymphovascular invasion; PNI: Perineural invasion; CCRT: Concurrent chemoradiotherapy; CEA: Carcinoembryonic antigen; CA19-9: Carbohydrate antigen 19-9; CRP: C-reactive protein; PLR: Platelet-to-lymphocyte ratio; NLR: Neutrophil-to-lymphocyte ratio; HR: Hazard ratio; CI: Confidence interval.

Table 2 Univariate and multivariate analyses for overall survival

	Univariate		Multivariate
	HR (95%CI)	P value	HR (95%CI)	P value
Sex (male)	1.752 (0.5667-5.416)	0.33
Age	0.992 (0.9545-1.031)	0.693
Size	0.924 (0.6395-1.334)	0.672
T stage	2.102 (0.6376-6.927)	0.222	3.015 (0.989-9.159)	0.052
LN metastasis (positive)	2.596 (0.967-6.968)	0.058	3.702 (1.116-12.283)	0.032^a
LVI (positive)	3.35 (1.226-9.153)	0.018^a	1.806 (0.549-5.941)	0.33
PNI (positive)	1.344 (0.5331-3.39)	0.531
Differentiation (poor)	1.398 (0.5406-3.617)	0.489
CCRT	1.073 (0.423-2.724)	0.881
Bilirubin	0.966 (0.8975-1.04)	0.359
CEA (≥ 5 ng/mL)	0.423 (0.0555-3.226)	0.407
CA19.9 (≥ 39 U/L)	1.372 (0.475-3.963)	0.559
CRP (≥ 0.5 mg/mL)	3.503 (0.7991-15.35)	0.096
Albumin (< 3.3 or > 5.2 mg/dL)	3.088 (0.6807-14.01)	0.144
PLR	1.003 (0.9991-1.007)	0.128
NLR	1.061 (0.9529-1.18)	0.282

^aP < 0.05.

Table 3 Baseline characteristics between the ampulla of Vater cancer patients with and without concurrent chemoradiotherapy

Characteristics	CCRT (n = 11)	Non-CCRT (n = 18)	Total (n = 29)	P value
Sex (%)				0.647
Male	9 (81.8)	12 (66.7)	21 (72.4)
Female	2 (18.2)	6 (33.3)	8 (27.6)
Age, median (IQR)	60 (52; 63)	75.5 (63.3; 79.5)	65 (60; 76)	0.007^b
Size, median (IQR)	2.9 (1.9; 3.8)	2.7 (2.2; 3.0)	2.7 (2.1; 3.2)	0.928
T stage (%)				0.200
2	3 (27.3)	2 (11.1)	5 (17.2)
3	7 (63.6)	16 (88.9)	23 (79.3)
4	1 (9.1)	0 (0.0)	1 (3.4)
LN metastasis (%)				1.000
Negative	5 (45.5)	9 (50.0)	14 (48.3)
Positive	6 (54.5)	9 (50.0)	15 (51.7)
LVI (%)				1.000
Negative	7 (63.6)	12 (66.7)	19 (65.5)
Positive	4 (36.4)	6 (33.3)	10 (34.5)
PNI (%)				0.661
Negative	5 (45.5)	11 (61.1)	16 (55.2)
Positive	6 (54.5)	7 (38.9)	13 (44.8)
Differentiation (%)				0.076
Well-to-moderate	4 (36.4)	14 (77.8)	18 (62.1)
Poor	6 (54.5)	3 (16.7)	9 (31.0)
Unknown	1 (9.1)	1 (5.6)	2 (6.9)
Bilirubin	4.6 (1.3; 11.9)	2.8 (0.5; 13.7)	4.1 (0.9; 12.9)	0.515
CEA (%)				1.000
< 5 ng/mL	8 (88.9)	14 (87.5)	22 (88.0)
≥ 5 ng/mL	1 (11.1)	2 (12.5)	3 (12.0)
CA19.9 (%)				0.866
< 39 U/L	3 (30.0)	7 (41.2)	10 (37.0)
≥ 39 U/L	7 (70.0)	10 (58.8)	17 (63.0)
CRP (%)				0.297
< 0.5 mg/dL	1 (11.1)	7 (38.9)	8 (29.6)
≥ 0.5 mg/dL	8 (88.9)	11 (61.1)	19 (70.4)
Albumin (%)				1.000
3.3-5.2 g/dL	10 (90.9)	17 (94.4)	27 (93.1)
< 3.3 or > 5.2 g/dL	1 (9.1)	1 (5.6)	2 (6.9)
PLR, median (IQR)	277.0 (215.1; 291.7)	159.8 (124.1; 237.9)	202.0 (133.9; 287.5)	0.044^a
NLR, median (IQR)	4.1 (3.3; 4.5)	2.7 (2.2; 4.7)	3.6 (2.3; 4.6)	0.334
ASA				0.105
I	3 (27.3)	0 (0.0)	3 (10.3)
II	6 (54.5)	11 (61.1)	17 (58.6)
III	2 (18.2)	6 (33.3)	8 (27.6)
IV	0 (0.0)	1 (5.6)	1 (3.4)

^aP < 0.05.

^bP < 0.01.

Citation: 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
URL: https://www.wjgnet.com/2307-8960/full/v12/i2/267.htm
DOI: https://dx.doi.org/10.12998/wjcc.v12.i2.267