Abstract
Background: Whether carcinomas of the ampulla of Vater should be classified with biliary tract tumors and treated in a similar manner remains unknown. We sought to compare the outcomes of similarly staged periampullary adenocarcinomas (AAs) and analyze the chemotherapy responsiveness of AAs. Patients and methods: A total of 905 patients with resected periampullary adenocarcinomas were identified from a prospective surgical registry from 1988 to 2010. A second cohort of 64 metastatic AA patients from 1992 to 2009 who received either front-line fluoropyrimidine-based or gemcitabine-based chemotherapy was also identified. Results: Overall survival (OS) for AAs was similar to survival with duodenal adenocarcinomas, but was significantly different from both extrahepatic biliary and pancreatic adenocarcinomas (P < 0.001 for each comparison). Inmultivariate analysis, AAs had a significantly improved OS in comparison with extrahepatic biliary adenocarcinomas (HR = 1.97, P=0.006). Fluoropyrimidine-based as opposed to gemcitabine-based chemotherapy for metastatic AAs resulted in a significant improvement in time to progression (P = 0.001) but only a trend toward benefit for OS (P = 0.07) in multivariate analysis. Conclusions: Differences in the natural history of ampullary and extrahepatic biliary adenocarcinomas exist. Analyses of metastatic ampullary adenocarcinomas suggest that fluoropyrimidine-based chemotherapy may represent a more appropriate front-line chemotherapy approach.
Original language | English (US) |
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Article number | mdt191 |
Pages (from-to) | 2349-2353 |
Number of pages | 5 |
Journal | Annals of Oncology |
Volume | 24 |
Issue number | 9 |
DOIs | |
State | Published - Sep 2013 |
Keywords
- Ampullary adenocarcinomas
- Chemotherapy
- Fluoropyrimidine
- Gemcitabine
- Periampullary
ASJC Scopus subject areas
- Hematology
- Oncology
MD Anderson CCSG core facilities
- Biostatistics Resource Group
- Clinical Trials Office