Adjuvant therapy for periampullary carcinoma and the significance of histopathological typing: A systematic review

Duan, Zhi-Qing; Tang, Yajie; Gao, Ruqing; Bao, Jing; Liang, Bo

doi:10.1016/j.tranon.2022.101414

Cited by 8 publications

(6 citation statements)

References 75 publications

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“…However, the patient still needs further management in the form of chemotherapy and genetic studies [ 9 , 10 ].…”

Section: Discussionmentioning

confidence: 99%

Challenges of Diagnosis: Periampullary Mass-Induced Obstructive Jaundice in a Young Woman

Gupta,

Kirnake,

Padwale

et al. 2024

Cureus

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Periampullary cancers, which include pancreatic adenocarcinoma, ampullary cancer, distal cholangiocarcinoma, and duodenal cancer, present diagnostic and management challenges due to their aggressive nature and nonspecific symptoms. We describe a case of a female patient, age 20, who had obstructive jaundice brought on by a periampullary tumor. Despite difficulties in diagnosis and treatment, including failed endoscopic retrograde cholangiopancreatography (ERCP), the patient underwent a successful pancreaticoduodenectomy (Whipple's resection), and subsequent immunohistochemistry revealed adenocarcinoma with a mixed immunophenotype expressing duodenal and pancreatic markers. This example emphasizes the significance of taking young patients' periampullary tumors into account, the difficulties in diagnosing them, and the possibility of effective surgical surgery throughout this age range.

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“…However, the patient still needs further management in the form of chemotherapy and genetic studies [ 9 , 10 ].…”

Section: Discussionmentioning

confidence: 99%

Challenges of Diagnosis: Periampullary Mass-Induced Obstructive Jaundice in a Young Woman

Gupta,

Kirnake,

Padwale

et al. 2024

Cureus

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“…Despite radical surgery, recurrences plague these tumors both early and late in the course. Segregation of pancreatic cancers from PACA has resulted in better understanding and management; however, the treatment strategies continue to be inspired by trials covering adjacent organs i.e., pancreas or colon or biliary tract cancers perse [7,8]. The rarity of the disease precludes randomized trials to assess the utility of adjuvant treatment in these cancers.…”

Section: Introductionmentioning

confidence: 99%

Role of adjuvant therapy in resected periampullary adenocarcinoma: A propensity matched case-control study

Srivastava,

Nekarakanti,

Kanchodu

et al. 2024

Ann Hepatobiliary Pancreat Surg

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Backgrounds/Aims:The published data had contradictory information on the role of adjuvant therapy on resected periampullary carcinomas (PACA). The study was performed to evaluate the survival benefit of adjuvant treatment. Methods: This was a propensity score matched case-control study from a prospectively maintained database from 2004-2019. The study included patients with nonpancreatic PACA who underwent curative resection. The patients (cases) who received adjuvant chemotherapy were compared with patients (controls) who were observed alone after surgery. Results: Of 510 patients with PACA, 230 patients (cases = 107, controls = 123) formed the unmatched study cohort. After propensity score matching, 140 patients (cases = 70, controls = 70) formed the matched study cohort. The median overall survival (OS) was similar in cases than controls in the unmatched population but doubled non-significantly in cases after matching (unmatched population, 54 months vs. 54 months, p -value = 0.624; matched population, 71 months vs. 36 months, p -value = 0.087). However, the median recurrence-free survival (RFS) was non significantly higher in the control group (unmatched population, 59 months vs. 38 months, p-value = 0.195; matched population, 53 months vs. 40 months, p-value = 0.797). In cox regression analysis, age < 60 years, advanced T stage, and presence of perineural invasion were independent factors for worse RFS, while tumor recurrence was an independent factor for poor OS. Conclusions: Patients with nonpancreatic PACA may have an OS benefit from adjuvant chemotherapy, and this needs to be validated with large prospective randomized studies.

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“…Periampullary carcinoma, which comprises ampulla of Vater, pancreatic head, distal common bile duct, and duodenal papillary cancers, is a malignant tumor originating 2 cm from the ampulla of Vater. 1 , 2 , 38 It constitutes 5% of all gastrointestinal tract malignancies and ranks eighth to ninth in incidence and the fourth to fifth most common cause of mortality in gastrointestinal tract malignancies. 3 , 4 …”

Section: Introductionmentioning

confidence: 99%

Remission from the 5-Fu-Based Chemotherapy to Gemcitabine-Based Chemotherapy-Based on the Pathological Classification of Periampullary Carcinoma: A Case Report and Literature Review

Hu¹,

Duan²,

Liu³

et al. 2022

OTT

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Background: Periampullary carcinoma, which includes ampullary carcinoma, pancreatic head cancer, distal common bile duct cancer, and duodenal papillary cancer, is a relatively rare malignancy with uncertain therapeutic options. Although several studies have investigated the efficacy of multiple adjuvant chemotherapy regimens for periampullary carcinoma treatment, the optimal regimen remains to be determined. The inherent heterogeneity of the mucosal origin divides periampullary carcinoma into intestinal and pancreaticobiliary types. Therefore, the selection of chemotherapy regimens based on pathological type may have potential therapeutic significance. Case Presentation: A 72-year-old woman with moderately differentiated periampullary adenocarcinoma experienced disease progression after receiving FOLFOX regimen. Subsequently, the sample was subtyped first by H&E evaluation and then by the evaluation of an IHC panel composed of CK20, CDX2, MUC1, MUC2, and MUC5AC. The pathologists concluded that the patient's sample was of the pancreaticobiliary (PB) subtype. The subsequent change to gemcitabine plus S-1 adjuvant therapy achieved remission of liver metastases based on the pathological classification of the cancer. Conclusion:Based on the pathological classification, adjuvant chemotherapy with gemcitabine may be beneficial for patients with PB subtype periampullary carcinoma. 5-Fu-based adjuvant chemotherapy may be beneficial for patients with intestinal subtype periampullary carcinoma.

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Adjuvant therapy for periampullary carcinoma and the significance of histopathological typing: A systematic review

Cited by 8 publications

References 75 publications

Challenges of Diagnosis: Periampullary Mass-Induced Obstructive Jaundice in a Young Woman

Challenges of Diagnosis: Periampullary Mass-Induced Obstructive Jaundice in a Young Woman

Role of adjuvant therapy in resected periampullary adenocarcinoma: A propensity matched case-control study

Remission from the 5-Fu-Based Chemotherapy to Gemcitabine-Based Chemotherapy-Based on the Pathological Classification of Periampullary Carcinoma: A Case Report and Literature Review

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