Adjuvant Therapy for Resected Ampulla Adenocarcinoma
| Author | Year | Number of patients | Study design | Treatment | Survival | p-value |
|---|---|---|---|---|---|---|
| Neoptolemos et al.93 (ESPAC-3 trial) | 2012 | PAC 428 (AA 297) | RCT | Gemcitabine or 5-FU/LV | OS: 43.1 months (AC) vs. 35.2 months (no AC) | 0.250 |
| Takada et al.94 | 2002 | PAC 508 (AA 48) | RCT | Mitomycin+5-FU | 5YSR of AA: 28.1% (AC) vs. 34.3% (no AC) | NS |
| Nassour et al.95 | 2018 | AA 4,190 | R | - | OS: 47.2 months (AC) vs. 35.5 months (no AC) | <0.01 |
| Moekotte et al.96 | 2020 | AA 1,163 | R | Gemcitabine-based AC | OS: Not reached (AC) vs. 60 months (no AC) | 0.051 |
| Kamarajah et al.97 | 2021 | AA 7,358 | R | - | OS: 47.5 months (AC) vs. 39.6 months (no AC) | 0.003 |
| Jin et al.98 | 2018 | AA 121 | R | AC (gemcitabine, 5-FU/LV, FOLFOX) or ART | OS: 45.5 months (AC or ART) vs. 34.3 months (no AC) | 0.030 |
| Acharya et al.99 (Meta-analysis) | 2017 | PAC 1,671 | R | AC or ART | 5YSR of AA: 40% (AC or ART) vs. 37.5% (no AC) | 0.067 |
| Smeenk et al.104 | 2007 | PAC 218 (AA 72) | RCT | ART (40 Gy) with 5-FU | OS: 20 months (ART) vs. 18 months (no ART) | NS |
| Klinkenbijl et al.105 (EORTC trial) | 1999 | PAC 93 | RCT | ART (40 Gy) with 5-FU | 5YSR of AA: 38% (ART) vs.36% (no ART) | 0.737 |
| Bhatia et al.101 | 2006 | AA 125 | R | ART (50.4 Gy) with 5-FU | OS: 3.4 years (ART) vs. 1.6 years (no ART) (in positive lymph node) | 0.01 |
| Palta et al.103 | 2012 | AA 137 | R | ART (50 Gy) with 5-FU or capecitabine | 3YSR: 62% (ART) vs. 46% (no ART) | 0.074 |
| Krishnan et al.106 | 2008 | AA 96 | R | ART (50.4 Gy) with 5-FU or capecitabine | OS: 35.2 months (ART) vs. 16.5 months (no ART) | 0.06 |
| Kwon et al.109 (Meta-analysis) | 2015 | AA 3,361 | R | ART+chemotherapy (5-FU, mostly) | Pooled OS: HR 0.75 | 0.01 |
| Manne et al.100 | 2020 | AA 63 | R | AC (capecitabine only) or ART (either capecitabine and 5-FU) | OS: 51.7 months (AC or ART) vs. 40.5 months (no AC or ART) | 0.93 |
ESPAC-3, European Study Group for Pancreatic Cancer-3; EORTC, European Organization for Research and Treatment of Cancer; PAC, periampullary carcinoma; AA, ampullary adenocarcinoma; RCT, randomized controlled trial; R, retrospective; 5-FU/LV, 5-fluorouracil/leucovorin; AC, adjuvant chemotherapy; ART, adjuvant radiotherapy; OS, overall survival; YSR, year survival rate; NS, not significant.