P-133 - Carcinoma of the amulla of vater: factors predictive of survival

Date 04 July 2015
Event WorldGI 2015
Session Posters
Topics Hepatobiliary Cancers
Presenter J. Martinez-Galán
Citation Annals of Oncology (2015) 26 (suppl_4): 1-100. 10.1093/annonc/mdv233
Authors J. Martinez-Galán1, L. Castillo1, J. Ruiz-Vozmediano1, L. Ochoa2, V. Amezcua3, J. García-García1, J.R. Delgado1, V. Conde1, J.A. Ortega1, C. Gonzalez4
  • 1Hospital Universitario Virgen de las Nieves, Granada/ES
  • 2SAS, Granada/ES
  • 3H.U. Virgen de las Nieves, Granada/ES
  • 4“Virgen de las Nieves” Hospital, Granada/ES

Abstract

Introduction

Carcinomas of the Ampulla of Vater are rare tumors. Compared with other biliary tract neoplasms, these tumors have a relatively favorable prognosis after surgical resection. Though Adenocarcinomas of the Ampulla of Vater (AAV) are classified as biliary cancers, the epithelium of origin and treatment approach for these rare tumors remains controversial.

Methods

We retrospectively evaluated 21 patients (pts) with adenocarcinomas of the ampulla of vater treated in our centre between 2000 and 2013. Primary endpoints were DFS and disease specific OS. Univariate analysis was used to estimate factors associated with outcomes. The Mann-Whitney test was applied to selected group comparisons.

Results

This collective consisted of 16 men (76%) and 5 women (24%). The median age was 62 years (42–77 years). Surgical resection was performed in all patients. After resection 48% (10/21) were T3-T4, 38% (8/21) had positive nodes, 14% (3/21) perineural invasion, 3/21 (14%) had vascular infiltration and 19% (4/21) had lymphatic invasion. Adjuvant chemotherapy had 14/21(67%) with gemcitabine and a median number of cycles 6. During median follow-up of 5 years tumor recurrence or metastatic disease occurred in 47% with median survival global were 3 years and 2.5 years for disease free survival. For stage T3-4, the median survival global rates were 27.5 months vs 59 months for T1-2 (p = 0.018) and for median recidive-free survival were 59 vs (p = 0.04). For N stage, the median survival global were 44 vs 27.5 months for negative nodes and positive nodes respectively (p < 0.05) and for median recidive-free survival were 44 vs 17.5 months for negative nodes and positive nodes respectively (p < 0.05). For lymphatic infiltration the median survival global were 41 vs 19 months for negative and positive infiltration respectively (p < 0.03). Other predictors factor as perineural invasion and vascular infiltration the median survival global rates were 23 vs 41 months and 27 vs 41 months in a present factors vs not present factors respectively, but not different significance perhaps for the low patients analyzed.

Conclusion

From our results T, N stage and lymphatic infiltration were predictors of DFS and OS after R0 resection for AAV. Although perineural invasion and vascular infiltration was associated with worse OS, required a larger sample size to know the impact of this factor in the patients with AAV