期刊
JOURNAL OF SURGICAL ONCOLOGY
卷 123, 期 7, 页码 1558-1567出版社
WILEY
DOI: 10.1002/jso.26435
关键词
ampullary carcinoma; neoadjuvant therapy; pancreatoduodenectomy
A study comparing neoadjuvant therapy followed by surgery with surgery first for ampullary carcinoma patients found no significant difference in overall survival outcomes, indicating that neoadjuvant therapy does not confer a survival advantage over surgery first in this population.
Background The role of neoadjuvant therapy (NT) for ampullary carcinoma (AC) has not been clearly established. Methods Patients who underwent pancreatoduodenectomy for AC between 2004 and 2016 were identified in the National Cancer Database. Overall survival (OS) was compared between those who received NT before resection and those who underwent surgery first (SF). Propensity score matching (PSM) was performed using age, pathologic T and N stage, and tumor differentiation. Results Among 8688 patients with AC, 175 (2.0%) received NT before surgery. While patients who received NT were younger (p = .022) and more likely to have nodal metastasis (43.3% vs. 35.1%, p < .001), there was no difference in OS on univariate (43 vs. 33 months; hazard ratio [HR]: 1.10, 95% confidence interval [CI]: 0.88-1.37, p = .401) or multivariate (HR: 1.09, 95% CI: 0.88-1.36, p = .416) analysis between groups. After PSM, there remained no difference in OS between NT or SF groups on univariate (37 vs. 32 months; HR: 1.20, 95% CI: 0.87-1.64, p = .350) or multivariate (HR: 0.99, 95% CI: 0.71-1.38, p = .943) analysis. Conclusion NT followed by surgery was not associated with improved survival outcomes compared with SF among patients with localized AC. While NT is an acceptable alternative for patients with advanced disease, SF should remain the standard of care.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据