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

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. (C) 2021 Elsevier Inc. All rights reserved.

Automated summary

Pathologic subtype and receipt of adjuvant therapy may impact survival in ampullary cancer patients, but stage remains the primary determinant of survival.