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同步放化疗对晚期壶腹癌的生存获益

Survival benefit of concurrent chemoradiotherapy for advanced ampulla of Vater cancer.

作者信息

Kwon Chae Hwa, Seo Hyung Il, Kim Dong Uk, Han Sung Yong, Kim Suk, Lee Nam Kyung, Hong Seung Baek, Ahn Ji Hyun, Park Young Mok, Noh Byeong Gwan

机构信息

BioMedical Research Institute, Pusan National University Hospital, Busan 49241, South Korea.

Department of Surgery, Pusan National University School of Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan 49241, South Korea.

出版信息

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

Abstract

BACKGROUND

Currently, there is no standard adjuvant therapy for patients with resected ampulla of Vater (AoV) cancer.

AIM

To evaluate the effectiveness of adjuvant concurrent chemoradiotherapy (CCRT) in patients with advanced AoV cancer who underwent curative resection.

METHODS

This single-centered, retrospective study included 29 patients with advanced AoV cancer who underwent pancreaticoduodenectomy between 2006 and 2018. The impact of CCRT on advanced AoV cancer was analyzed.

RESULTS

The 1-, 3-, and 5-yr recurrence-free survival (RFS) rates for patients with advanced AoV cancer were 82.8%, 48.3%, and 40.8%, respectively, and the overall survival (OS) rates were 89.7%, 62.1%, and 51.7%, respectively. Lymphovascular invasion was found to be a significant risk factor for RFS and OS in patients with advanced AoV cancer in the univariate analysis, whereas T stage and lymph node metastasis were significantly associated with OS in the multivariate analysis. Compared to the patients who did not receive adjuvant CCRT, those who received adjuvant CCRT did not show statistically significant improvements in the RFS and OS, although they had a significantly lower average age and significantly higher platelet-to-lymphocyte ratio.

CONCLUSION

Adjuvant CCRT did not improve survival outcomes in patients with advanced AoV cancer. These findings contribute to existing knowledge on the effectiveness of CCRT in this patient population and provide important insights for clinical decision-making.

摘要

背景

目前,对于已切除的壶腹癌(AoV)患者尚无标准的辅助治疗方法。

目的

评估辅助同步放化疗(CCRT)对接受根治性切除的晚期AoV癌患者的疗效。

方法

这项单中心回顾性研究纳入了2006年至2018年间接受胰十二指肠切除术的29例晚期AoV癌患者。分析了CCRT对晚期AoV癌的影响。

结果

晚期AoV癌患者的1年、3年和5年无复发生存率(RFS)分别为82.8%、48.3%和40.8%,总生存率(OS)分别为89.7%、62.1%和51.7%。单因素分析发现,血管侵犯是晚期AoV癌患者RFS和OS的显著危险因素,而多因素分析显示T分期和淋巴结转移与OS显著相关。与未接受辅助CCRT的患者相比,接受辅助CCRT的患者虽然平均年龄显著更低、血小板与淋巴细胞比值显著更高,但在RFS和OS方面并未显示出统计学上的显著改善。

结论

辅助CCRT并未改善晚期AoV癌患者的生存结局。这些发现有助于丰富关于CCRT在该患者群体中疗效的现有知识,并为临床决策提供重要见解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c48c/10835681/03da05a40383/WJCC-12-267-g001.jpg

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