Survival Benefit of Adjuvant Chemoradiotherapy in Patients With Ampulla of Vater Cancer: A Systematic Review and Meta-analysis

Annals of Surgery
Jeanny KwonSung W Ha

Abstract

We conducted a systematic review and meta-analysis focusing on the impact of adjuvant radiotherapy (RT) on overall survival (OS) in ampulla of Vater (AoV) cancer. The adjuvant treatment for AoV cancer is a subject of controversy without convincing evidence from randomized study. A comprehensive search was performed in the databases of EMBASE, PubMed, Web of Science, Cochrane Library, and Ovid from inception to July 2014. We included studies, which compared survival between patients with or without adjuvant RT after curative surgery solely for AoV cancer. Hazard ratio (HR) for OS was extracted, and a random-effects model was used for pooled analysis. Ten retrospective studies including 3361 patients met all inclusion criteria and were included for the final meta-analysis. Adjuvant RT was delivered with concurrent chemotherapy, mostly 5-fluorouracil, in all institutional studies. Generally, adjuvant RT groups included more patients with locally advanced disease or lymph node metastasis than did the surgery alone groups. The pooled results demonstrated that adjuvant RT significantly reduced the risk of death (HR = 0.75; P = 0.01). Exploratory analyses showed that patients with lymph node metastasis (HR = 0.52; P = 0.001) and local...Continue Reading

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Citations

Nov 12, 2017·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Ibrahim NassourSam C Wang
Mar 9, 2019·Journal of Hepato-biliary-pancreatic Sciences·Hongbeom KimSun-Whe Kim
Feb 22, 2018·Journal of Gastrointestinal Cancer·Saphalta BaghmarViniyendra Pamecha
Jan 14, 2020·Clinical & Translational Oncology : Official Publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico·M BonetM Mira
Jun 13, 2019·Journal of Oncology·Mohammed Al-JumayliAnup Kasi
Apr 8, 2020·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Xi-Tai HuangXiao-Yu Yin
Nov 10, 2020·Annals of Surgical Treatment and Research·Chung Hyeun MaSong Cheol Kim
Mar 14, 2021·European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology·Evelien J M de JongUNKNOWN Dutch Pancreatic Cancer Group (DPCG)
Apr 3, 2021·Pancreatology : Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]·G NappoA Zerbi
Nov 11, 2020·Cancer Research and Treatment : Official Journal of Korean Cancer Association·Jwa Hoon KimKi Byung Song
Jul 7, 2021·Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen·Timm M Reißig, Jens T Siveke
Sep 30, 2021·Current Treatment Options in Oncology·Monica Patel, Nataliya V Uboha

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