Detailed Abstract
[BP Oral Presentation 1 - Biliary Disease/Surgery]
[BP OP 1-1] Evaluation of postadjuvant therapy for ampulla of vater carcinoma : Multicenter, retrospective study
Hyung Sun KIM1, Joon Seong PARK1, Jin Young JANG2, Wooil KWON2, Sun Whe KIM2, Yoo Seok YOON3, Ho Seong HAN3, Dong Sup YOON1, Sang Jae PARK4, SungSik HAN4, SeongHoon KIM4
1Department of Surgery, Pancreatobiliary Cancer Clinic, Gangnam Severance Hospital, Yonsei University College of Medicine, Korea
2Department of Surgery, Seoul National University College of Medicine, Korea
3Department of Surgery, Seoul National University Bundang Hospital, Seoul National University, Korea
4Center for Liver Cancer, National Cancer Center, Goyang, Korea, Korea
Introduction : Ampulla of vater carcinoma (AOV) is an infrequent tumor that account for about 0.2% of gastrointestinal malignancies. The incidence of AOV carcinoma is steadily increasing. But there are no guidelines from both the NCCN and the ESMO for the treatment of advanced AOV carcinoma. Only a few retrospective studies have focused on the adjuvant treatment in AOV carcinoma. So, we conducted multicenter retrospective review for evaluation of postadjuvant therapy for AOV carcinoma.
Methods : Patients who underwent curative resection for AOV carcinoma at the four hospital ( Yonsei Gangnam severance hospital, Seoul national university hospital, Seoul national university bundang hospital, National cancer center , n =715; 2002-2015) were reviewed. Patients with metastatic disease at surgery, or insufficient pathologic data were excluded. Adjuvant treatment were chemotherapy or chemoradiotherapy. Overall survival and recurrence free survival was compared using Kaplan –Meier estimates.
Results : In univariate analysis, locally advanced T stage (T3-4) and node positive, perineural invasion, lymphovascular invasion, moderately cell differentiation were associated with adjuvant treatment. ( p = < 0.001) No adjuvant group(Group 1) were 437 patient and adjuvant treatment group were 272 patients (Chemotherapy,Group 2; 94 patients, Chemoradiotherapy, Group 3; 184 patients). In the high risk patients, such as patients with node-positive, Group 3 was significantly associated with increased recurrence free survival (p = <0.05).
Conclusions : Adjuvant treatment did not improve survival in low risk patients. However adjuvant chemoradiation treatment maybe improved recurrence free survival in high risk patients ( node-positive, advanced stage ) . Prospective evaluation of appropriate adjuvant treatment should be considered.
Methods : Patients who underwent curative resection for AOV carcinoma at the four hospital ( Yonsei Gangnam severance hospital, Seoul national university hospital, Seoul national university bundang hospital, National cancer center , n =715; 2002-2015) were reviewed. Patients with metastatic disease at surgery, or insufficient pathologic data were excluded. Adjuvant treatment were chemotherapy or chemoradiotherapy. Overall survival and recurrence free survival was compared using Kaplan –Meier estimates.
Results : In univariate analysis, locally advanced T stage (T3-4) and node positive, perineural invasion, lymphovascular invasion, moderately cell differentiation were associated with adjuvant treatment. ( p = < 0.001) No adjuvant group(Group 1) were 437 patient and adjuvant treatment group were 272 patients (Chemotherapy,Group 2; 94 patients, Chemoradiotherapy, Group 3; 184 patients). In the high risk patients, such as patients with node-positive, Group 3 was significantly associated with increased recurrence free survival (p = <0.05).
Conclusions : Adjuvant treatment did not improve survival in low risk patients. However adjuvant chemoradiation treatment maybe improved recurrence free survival in high risk patients ( node-positive, advanced stage ) . Prospective evaluation of appropriate adjuvant treatment should be considered.
SESSION
BP Oral Presentation 1
Room C 3/30/2018 10:10 AM - 11:00 AM