切除性壶腹癌的肿瘤学结果：组织学亚型和辅助化疗的相关性。

Oncologic outcomes in resected ampullary cancer: Relevance of histologic subtype and adjuvant chemotherapy.

机构信息

Oregon Health & Science University (OHSU), Department of Surgery, Division of Surgical Oncology, 3181 SW Sam Jackson Park Road, Portland, OR, 97239, USA.

OHSU, Department of Pathology, 3181 SW Sam Jackson Park Road, Portland, OR, 97239, USA.

出版信息

Am J Surg. 2021 Jun;221(6):1128-1134. doi: 10.1016/j.amjsurg.2021.04.001. Epub 2021 Apr 8.

DOI:10.1016/j.amjsurg.2021.04.001

PMID:33883071

Abstract

BACKGROUND

Outcomes in ampullary cancer (AC) may differ by pathologic subtype. No guidelines exist for the administration of adjuvant therapy (AT). We sought to evaluate the effect of subtype and AT on survival.

METHODS

An institutional review of patients undergoing resection for AC from 2008-17 was performed. Recurrence-free (RFS) and overall survival (OS) were assessed by Kaplan-Meier and Cox proportional hazards modeling.

RESULTS

Of 53 patients, two-thirds (62%) were stage III. Histologic subtype was evenly split between intestinal and pancreatobiliary (43% and 40%). Half of patients received AT. RFS and OS were 25 (95% CI 16-32) and 41 (CI 22-60) months, respectively, without significant difference by subtype. Stage II/III disease was associated with worse OS (HR 3.7, P = 0.03), which was improved with receipt of AT (HR 0.44, P < 0.05).

CONCLUSION

Stage is the primary determinant of survival in AC, which may be improved with AT.

摘要

背景

壶腹癌（AC）的预后可能因病理亚型而异。目前尚无关于辅助治疗（AT）管理的指南。我们旨在评估亚型和 AT 对生存的影响。

方法

对 2008 年至 2017 年接受 AC 切除术的患者进行机构审查。通过 Kaplan-Meier 和 Cox 比例风险模型评估无复发生存（RFS）和总生存（OS）。

结果

在 53 名患者中，三分之二（62%）为 III 期。组织学亚型在肠型和胰胆型之间平分秋色（43%和 40%）。一半的患者接受了 AT。RFS 和 OS 分别为 25 个月（95%CI 16-32）和 41 个月（CI 22-60），但亚型之间无显著差异。II/III 期疾病与 OS 较差相关（HR 3.7，P=0.03），而接受 AT 可改善 OS（HR 0.44，P<0.05）。