Anticancer research · 2026
Prognostic Factors and the Impact of Adjuvant S-1 Chemotherapy in Resected Ampulla of Vater Carcinoma: A Single-institution Retrospective Study.
СтатьяНазвание и аннотация: Перевод в очереди
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Imamura Hajime, Adachi Tomohiko, Hamada Takashi, Migita Kazushige, Satoh Ayaka, Kurotaki Kouki, Nakamura Shun, Ogawa Shinichiro, Askeyev Baglan, Matsushima Hajime, Kinoshita Ayaka, Soyama Akihiko, Eguchi Susumu
Аннотация
BACKGROUND/AIM: Ampulla of Vater carcinoma is a rare malignancy with limited survival after resection, and the role of adjuvant therapy remains unclear. S-1 (oral prodrug of 5-FU with modulators gimeracil and oteracil) has been adopted as an adjuvant treatment for biliary cancers in Japan, but its benefit in ampullary carcinoma is uncertain. We aimed to identify prognostic factors and evaluate the impact of adjuvant S-1 in resected ampullary carcinoma.
PATIENTS AND METHODS: We retrospectively reviewed 53 patients who underwent pancreatoduodenectomy for ampullary carcinoma at a single institution (2005-2023). Clinicopathologic data and use of adjuvant S-1 were collected. Cancer-specific survival (CSS) and relapse-free survival (RFS) were estimated by the Kaplan-Meier method and compared by the log-rank test. Cox proportional hazards models identified independent prognostic factors. Outcomes with versus without adjuvant S-1 were compared within the node-positive (N+) subset of patients.
RESULTS: The 5-year CSS and RFS for all patients were 70.8% and 66.2%, respectively. On multivariate analysis, lymph node metastasis (N+) was the only independent predictor of worse CSS (p=0.04) and RFS (p=0.001). Among N+ patients (n=20), 5-year CSS (51.4% vs. not reached) and RFS (18.0% vs. 18.7%) were similar with adjuvant S-1 (n=11) or surgery alone (n=9) (p=0.5 and 0.4). Adjuvant S-1 did not improve survival in node-positive patients.
CONCLUSION: Lymph node status is a major prognostic factor in ampullary carcinoma. Adjuvant S-1 chemotherapy conferred no significant survival benefit for node-positive patients, underscoring the need for more effective adjuvant strategies.
PATIENTS AND METHODS: We retrospectively reviewed 53 patients who underwent pancreatoduodenectomy for ampullary carcinoma at a single institution (2005-2023). Clinicopathologic data and use of adjuvant S-1 were collected. Cancer-specific survival (CSS) and relapse-free survival (RFS) were estimated by the Kaplan-Meier method and compared by the log-rank test. Cox proportional hazards models identified independent prognostic factors. Outcomes with versus without adjuvant S-1 were compared within the node-positive (N+) subset of patients.
RESULTS: The 5-year CSS and RFS for all patients were 70.8% and 66.2%, respectively. On multivariate analysis, lymph node metastasis (N+) was the only independent predictor of worse CSS (p=0.04) and RFS (p=0.001). Among N+ patients (n=20), 5-year CSS (51.4% vs. not reached) and RFS (18.0% vs. 18.7%) were similar with adjuvant S-1 (n=11) or surgery alone (n=9) (p=0.5 and 0.4). Adjuvant S-1 did not improve survival in node-positive patients.
CONCLUSION: Lymph node status is a major prognostic factor in ampullary carcinoma. Adjuvant S-1 chemotherapy conferred no significant survival benefit for node-positive patients, underscoring the need for more effective adjuvant strategies.