首页|Survival benefit of adjuvant treatment for ampullary cancer with lymph nodal involvement:A systematic review and meta-analysis
Survival benefit of adjuvant treatment for ampullary cancer with lymph nodal involvement:A systematic review and meta-analysis
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Background:The efficacy of adjuvant treatment(AT)in ampullary cancer(AmC)remains controversial.This systematic review and meta-analysis aimed to evaluate the role of AT for AmC.Data sources:A comprehensive systematic search was performed in PubMed,EMBASE,Cochrane Library,and Web of Science databases.Studies comparing overall survival(OS)and recurrence-free survival(RFS)of patients who underwent AT or not following AmC resection were included.Results:A total of 3971 patients in 21 studies were analyzed.Overall pooled data showed no significant difference in effect on the OS by AT[hazard ratio(HR)=0.998,95％confidence interval(CI):0.768-1.297].No significant difference in recurrence between the AT and non-AT(nAT)groups was noted(HR=1.158,95％CI:0.764-1.755).In subgroup analysis,patients who received AT showed favorable outcomes in the OS compared with those who received nAT in nodal-positive AmC(HR=0.627,95％CI:0.451-0.870).Neither AT consisted of adjuvant chemotherapy with radiotherapy(HR=0.804,95％Cl:0.563-1.149)nor AT with adjuvant chemotherapy(HR=0.883,95％CI:0.642-1.214)showed any significant effect on the OS.Conclusions:The effect of AT in AmC on survival and recurrence did not show a significant benefit.Furthermore,effectiveness according to AT strategies did not show enhancement in survival.AT had an advantage in survival compared with nAT strategy in nodal-positive AmC.In cases of AmC with positive lymph nodal involvement,AT may be warranted regardless of detailed strategies.
Ampulla of VaterAdjuvant chemotherapyAdjuvant chemoradiotherapyMeta-analysis
Min Kyu Kim、Jin Ho Choi、In Rae Cho、Sang Hyub Lee、Ji Kon Ryu、Yong-Tae Kim、Woo Hyun Paik
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Department of Gastroenterology,Asan Medical Center,University of Ulsan College of Medicine,Seoul,Korea
Department of Internal Medicine,Liver Research Institute,Seoul National University Hospital,Seoul National University College of Medicine,Seoul,Korea
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