A retrospective study of ampullary adenocarcinomas: Overall survival and responsiveness to fluoropyrimidinebased chemotherapy

Z. Q. Jiang, G. Varadhachary, X. Wang, S. Kopetz, J. E. Lee, H. Wang, R. Shroff, M. Katz, R. A. Wolff, J. Fleming, M. J. Overman

Research output: Contribution to journalArticlepeer-review

23 Scopus citations

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 languageEnglish (US)
Article numbermdt191
Pages (from-to)2349-2353
Number of pages5
JournalAnnals of Oncology
Volume24
Issue number9
DOIs
StatePublished - Sep 2013
Externally publishedYes

Keywords

  • Ampullary adenocarcinomas
  • Chemotherapy
  • Fluoropyrimidine
  • Gemcitabine
  • Periampullary

ASJC Scopus subject areas

  • Hematology
  • Oncology

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