S-Space College of Medicine/School of Medicine (의과대학/대학원) Internal Medicine (내과학전공) Journal Papers (저널논문_내과학전공)
Prognostic significance of tumour location after adjuvant chemoradiotherapy for periampullary adenocarcinoma
- Kim, Kyubo; Chie, Eui Kyu; Jang, Jin-Young; Kim, Sun Whe; Han, Sae-Won; Oh, Do-Youn; Im, Seock-Ah; Kim, Tae-You; Bang, Yung-Jue; Ha, Sung W.
- Issue Date
- Clinical and Translational Oncology, Vol.14 No.5, pp.391-395
- To analyse the outcome of adjuvant chemoradiotherapy for periampullary adenocarcinoma and the impact of tumour location as a prognosticator. Between January 1991 and December 2002, 147 patients with periampullary cancer underwent adjuvant chemoradiotherapy after pancreaticoduodenectomy. Postoperative radiotherapy was delivered to tumour bed and regional lymph nodes up to 40 Gy at 2 Gy/fraction with a two-week planned rest. Intravenous 5-fluorouracil (500 mg/m(2)/day) was given on days 1-3 of each split course. The median follow-up period was 82 months in survivors. Tumour > 2 cm and margin-positivity were more common in patients with pancreatic cancer than nonpancreatic periampullary cancers (p < 0.0001 and 0.0780, respectively). According to the tumour location, 5-year overall survival rates of ampulla of Vater, distal common bile duct, duodenal and pancreatic head cancers were 53.0%, 50.3%, 37.5%, and 13.0%, respectively (p < 0.0001). On multivariate analysis, pancreatic location (p < 0.0001) and nodal involvement (p=0.0123) were associated with inferior overall survival. Regardless of its advanced histologic features, pancreatic location itself was an adverse prognostic factor affecting overall survival.
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