Abstract 1486P
Background
Ampullary cancers represent a subset of periampullary carcinoma, accounting for only 0.2% gastrointestinal cancers. Localised disease is treated with pancreaticoduodenectomy followed by chemo-radiation or chemotherapy. In this study, various clinico-pathologic factors were assessed for recurrence and survival.
Methods
64 patients; post pancreaticoduodenectomy; were studied over the time period of 10 years from 2009-2019.Survival rates were calculated using Kaplan-Meier method .The significance of clinical and histopathological factors with regard to survival was determined using Univariate and multivariate analysis. Log rank test and Cox regression analysis were used. Prognostic role of adjuvant radiotherapy and chemotherapy was also analysed with respect to overall survival (OS) and progression-free survival (PFS). SPSS version 25.0 was used for statistical analysis.
Results
Median age of presentation was 57.5 years. Majority (87.5%) of the patients presented with pain abdomen;12.5% had nausea and vomiting.The most common stage of presentation was stage IB (35.9%); closely followed by IIIA (31.3%). In total, 33 (51.5%) patients recurred; liver being the commonest(18.75%), followed by abdominal lymphadenopathy (9.3%),lung (4.6%),adrenal gland (1.6%) and local (15.6%).On univariate analysis, perinodal extension(p=0.001) and adjuvant radiotherapy (p=0.02) were found to be significantly associated with poor OS.On multivariate analysis, both these factors retained significance. Adjuvant chemotherapy (p=0.03) was found to independently influence the PFS on univariate analysis, though this significance was not retained on multivariate analysis.78% patients got adjuvant radiotherapy and 83% received chemotherapy. Kaplan Meir curves were not significant for OS and PFS for staging and pathological differentiation of tumors.Median OS and PFS was 28.5 and 27 months.
Conclusions
The management in ampullary carcinoma remains challenging with a clear lack of evidence based standard of care treatment guidelines. Addition of adjuvant therapies like radiotherapy and chemotherapy improves the survival. Keywords: Adjuvant; Ampullary cancer; Chemotherapy; Radiotherapy.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.