Survival Outcomes According to Adjuvant Treatment and Prognostic Factors Including Host Immune Markers in Patients with Curatively Resected Ampulla of Vater Cancer
Ampulla of Vater cancer (AoV Ca) is a rare tumor, and its adjuvant treatment has not been established. The purpose of this study was to find out prognostic factors including host immunity and role of adjuvant treatment in AoV Ca. We reviewed 227 AoV Ca patients with curative resection. Clinical char...
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| Veröffentlicht in: | PloS one 2016-03, Vol.11 (3), p.e0151406-e0151406 |
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| creator | Ha, Hye Rim Oh, Do-Youn Kim, Tae-Yong Lee, KyoungBun Kim, Kyubo Lee, Kyung-Hun Han, Sae-Won Chie, Eui Kyu Jang, Jin-Young Im, Seock-Ah Kim, Tae-You Kim, Sun-Whe Bang, Yung-Jue |
| description | Ampulla of Vater cancer (AoV Ca) is a rare tumor, and its adjuvant treatment has not been established. The purpose of this study was to find out prognostic factors including host immunity and role of adjuvant treatment in AoV Ca.
We reviewed 227 AoV Ca patients with curative resection. Clinical characteristics, adjuvant treatment, disease-free survival (DFS) and overall survival (OS) were analyzed. Among all patients, 63.9, 36.1 and 33.9% had T1/T2, T3/T4 stage and lymph node-positive disease (LN+), respectively. OS of all patients was 90.9 months (95% CI: 52.9-129.0). OS was different according to neutrophil-to-lymphocyte ratio (HR 1.651, 95% CI: 1.11-2.47), platelet-to-lymphocyte ratio (HR 1.488, 95% CI: 1.00-2.21) and systemic inflammatory index (HR 1.669, 95% CI: 1.13-2.47). In multivariate analysis, adverse prognostic factors for OS included vascular invasion (HR 2.571, 95% CI: 1.20-5.53) and elevated CA 19-9 (HR 1.794, 95% CI: 1.07-3.05). A total of 104 patients (46.3%) received adjuvant treatment (25 out of 111of T1/T2 & LN (-), 79 out of 116 of T3/T4 or LN (+)). In T3/T4 or LN (+) stage, adjuvant CCRT with maintenance chemotherapy provided the longest OS (5-year OS rate: 47.0 vs. 41.4%).
Vascular invasion and elevated CA 19-9 were adverse prognostic factors in resected AoV Ca. In T3/T4 or LN (+) stage, adjuvant CCRT with maintenance chemotherapy provided the best survival outcome. Adjuvant treatment should be further defined in AoV Ca, especially with poor prognostic factors. |
| doi_str_mv | 10.1371/journal.pone.0151406 |
| format | Article |
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We reviewed 227 AoV Ca patients with curative resection. Clinical characteristics, adjuvant treatment, disease-free survival (DFS) and overall survival (OS) were analyzed. Among all patients, 63.9, 36.1 and 33.9% had T1/T2, T3/T4 stage and lymph node-positive disease (LN+), respectively. OS of all patients was 90.9 months (95% CI: 52.9-129.0). OS was different according to neutrophil-to-lymphocyte ratio (HR 1.651, 95% CI: 1.11-2.47), platelet-to-lymphocyte ratio (HR 1.488, 95% CI: 1.00-2.21) and systemic inflammatory index (HR 1.669, 95% CI: 1.13-2.47). In multivariate analysis, adverse prognostic factors for OS included vascular invasion (HR 2.571, 95% CI: 1.20-5.53) and elevated CA 19-9 (HR 1.794, 95% CI: 1.07-3.05). A total of 104 patients (46.3%) received adjuvant treatment (25 out of 111of T1/T2 & LN (-), 79 out of 116 of T3/T4 or LN (+)). In T3/T4 or LN (+) stage, adjuvant CCRT with maintenance chemotherapy provided the longest OS (5-year OS rate: 47.0 vs. 41.4%).
Vascular invasion and elevated CA 19-9 were adverse prognostic factors in resected AoV Ca. In T3/T4 or LN (+) stage, adjuvant CCRT with maintenance chemotherapy provided the best survival outcome. Adjuvant treatment should be further defined in AoV Ca, especially with poor prognostic factors.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0151406</identifier><identifier>PMID: 26974670</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adjuvant chemotherapy ; Adjuvant therapy ; Adult ; Aged ; Aged, 80 and over ; Ampulla of Vater ; Ampulla of Vater - immunology ; Ampulla of Vater - surgery ; Analysis ; Antigens ; Biliary tract cancer ; Biology and Life Sciences ; Biomarkers, Tumor - metabolism ; Cancer ; Cancer therapies ; Care and treatment ; Chemotherapy ; Chemotherapy, Adjuvant ; Colorectal cancer ; Common Bile Duct Neoplasms - drug therapy ; Common Bile Duct Neoplasms - immunology ; Common Bile Duct Neoplasms - surgery ; Development and progression ; Female ; Gallbladder ; Genetic aspects ; Hospitals ; Humans ; Immunity ; Inflammation ; Internal medicine ; Laboratories ; Liver cancer ; Lymph nodes ; Lymphatic system ; Lymphocytes ; Lymphocytes - immunology ; Male ; Medical prognosis ; Medical research ; Medical treatment ; Medicine ; Medicine and Health Sciences ; Middle Aged ; Multivariate analysis ; Neoplasm Staging ; Neutrophils - immunology ; Oncology ; Patients ; Prognosis ; Radiation therapy ; Statistical analysis ; Studies ; Surgery ; Survival ; Survival Analysis ; Systematic review ; Treatment Outcome ; Tumors</subject><ispartof>PloS one, 2016-03, Vol.11 (3), p.e0151406-e0151406</ispartof><rights>COPYRIGHT 2016 Public Library of Science</rights><rights>2016 Ha et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2016 Ha et al 2016 Ha et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-1944e3d9fa5120d65de233f77993c25bda31b0b0af2b37c90e2203f2ce22e7ae3</citedby><cites>FETCH-LOGICAL-c692t-1944e3d9fa5120d65de233f77993c25bda31b0b0af2b37c90e2203f2ce22e7ae3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4790941/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4790941/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2095,2914,23846,27903,27904,53770,53772,79347,79348</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26974670$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Souglakos, John</contributor><creatorcontrib>Ha, Hye Rim</creatorcontrib><creatorcontrib>Oh, Do-Youn</creatorcontrib><creatorcontrib>Kim, Tae-Yong</creatorcontrib><creatorcontrib>Lee, KyoungBun</creatorcontrib><creatorcontrib>Kim, Kyubo</creatorcontrib><creatorcontrib>Lee, Kyung-Hun</creatorcontrib><creatorcontrib>Han, Sae-Won</creatorcontrib><creatorcontrib>Chie, Eui Kyu</creatorcontrib><creatorcontrib>Jang, Jin-Young</creatorcontrib><creatorcontrib>Im, Seock-Ah</creatorcontrib><creatorcontrib>Kim, Tae-You</creatorcontrib><creatorcontrib>Kim, Sun-Whe</creatorcontrib><creatorcontrib>Bang, Yung-Jue</creatorcontrib><title>Survival Outcomes According to Adjuvant Treatment and Prognostic Factors Including Host Immune Markers in Patients with Curatively Resected Ampulla of Vater Cancer</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Ampulla of Vater cancer (AoV Ca) is a rare tumor, and its adjuvant treatment has not been established. The purpose of this study was to find out prognostic factors including host immunity and role of adjuvant treatment in AoV Ca.
We reviewed 227 AoV Ca patients with curative resection. Clinical characteristics, adjuvant treatment, disease-free survival (DFS) and overall survival (OS) were analyzed. Among all patients, 63.9, 36.1 and 33.9% had T1/T2, T3/T4 stage and lymph node-positive disease (LN+), respectively. OS of all patients was 90.9 months (95% CI: 52.9-129.0). OS was different according to neutrophil-to-lymphocyte ratio (HR 1.651, 95% CI: 1.11-2.47), platelet-to-lymphocyte ratio (HR 1.488, 95% CI: 1.00-2.21) and systemic inflammatory index (HR 1.669, 95% CI: 1.13-2.47). In multivariate analysis, adverse prognostic factors for OS included vascular invasion (HR 2.571, 95% CI: 1.20-5.53) and elevated CA 19-9 (HR 1.794, 95% CI: 1.07-3.05). A total of 104 patients (46.3%) received adjuvant treatment (25 out of 111of T1/T2 & LN (-), 79 out of 116 of T3/T4 or LN (+)). In T3/T4 or LN (+) stage, adjuvant CCRT with maintenance chemotherapy provided the longest OS (5-year OS rate: 47.0 vs. 41.4%).
Vascular invasion and elevated CA 19-9 were adverse prognostic factors in resected AoV Ca. In T3/T4 or LN (+) stage, adjuvant CCRT with maintenance chemotherapy provided the best survival outcome. Adjuvant treatment should be further defined in AoV Ca, especially with poor prognostic factors.</description><subject>Adjuvant chemotherapy</subject><subject>Adjuvant therapy</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Ampulla of Vater</subject><subject>Ampulla of Vater - immunology</subject><subject>Ampulla of Vater - surgery</subject><subject>Analysis</subject><subject>Antigens</subject><subject>Biliary tract cancer</subject><subject>Biology and Life Sciences</subject><subject>Biomarkers, Tumor - metabolism</subject><subject>Cancer</subject><subject>Cancer therapies</subject><subject>Care and treatment</subject><subject>Chemotherapy</subject><subject>Chemotherapy, Adjuvant</subject><subject>Colorectal cancer</subject><subject>Common Bile Duct Neoplasms - drug therapy</subject><subject>Common Bile Duct Neoplasms - immunology</subject><subject>Common Bile Duct Neoplasms - surgery</subject><subject>Development and progression</subject><subject>Female</subject><subject>Gallbladder</subject><subject>Genetic aspects</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Immunity</subject><subject>Inflammation</subject><subject>Internal medicine</subject><subject>Laboratories</subject><subject>Liver cancer</subject><subject>Lymph nodes</subject><subject>Lymphatic system</subject><subject>Lymphocytes</subject><subject>Lymphocytes - immunology</subject><subject>Male</subject><subject>Medical prognosis</subject><subject>Medical research</subject><subject>Medical treatment</subject><subject>Medicine</subject><subject>Medicine and Health Sciences</subject><subject>Middle Aged</subject><subject>Multivariate analysis</subject><subject>Neoplasm Staging</subject><subject>Neutrophils - immunology</subject><subject>Oncology</subject><subject>Patients</subject><subject>Prognosis</subject><subject>Radiation therapy</subject><subject>Statistical analysis</subject><subject>Studies</subject><subject>Surgery</subject><subject>Survival</subject><subject>Survival Analysis</subject><subject>Systematic review</subject><subject>Treatment Outcome</subject><subject>Tumors</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>DOA</sourceid><recordid>eNqNk11v0zAUhiMEYmPwDxBYQkJw0eKPfDQ3SFXFWKWhTtvYrXXinLQuiV1sp7Dfwx_FXbupRbtAubBjP-974jc-SfKa0SETBfu0tL0z0A5X1uCQsoylNH-SHLNS8EHOqXi6Nz9KXni_pDQTozx_nhzxvCzSvKDHyZ-r3q31Gloy64OyHXoyVsq6Wps5CZaM62W_BhPItUMIHcYZmJpcODs31getyCmoYJ0nU6Pa_k52FjfItOt6g-QbuB8Yd7UhFxB01HvyS4cFmfQuvq-xvSWX6FEFrMm4W_VtC8Q25AYCOjIBo9C9TJ410Hp8tRtPku-nX64nZ4Pz2dfpZHw-UHnJw4CVaYqiLhvIGKd1ntXIhWiKoiyF4llVg2AVrSg0vBKFKinyGE3DVRyxABQnydut76q1Xu7y9ZIVheC5oDSPxHRL1BaWcuV0B-5WWtDybsG6uQQXQ2lRZlAARQHpiFZpnmeQYVaXtBw1lQKRptHr865aX3VYqxiNg_bA9HDH6IWc27VMi2iTsmjwYWfg7M8efZCd9gpjgAZtv_3uEaMl39R69w_6-Ol21BziAbRpbKyrNqZynGYiLeIV45EaPkLFp8ZOq3gZGx3XDwQfDwSRCfg7zKH3Xk6vLv-fnd0csu_32AVCGxbetn3Q1vhDMN2CylnvHTYPITMqN710n4bc9JLc9VKUvdn_QQ-i--YRfwGD1Rue</recordid><startdate>20160314</startdate><enddate>20160314</enddate><creator>Ha, Hye Rim</creator><creator>Oh, Do-Youn</creator><creator>Kim, Tae-Yong</creator><creator>Lee, KyoungBun</creator><creator>Kim, Kyubo</creator><creator>Lee, Kyung-Hun</creator><creator>Han, Sae-Won</creator><creator>Chie, Eui Kyu</creator><creator>Jang, Jin-Young</creator><creator>Im, Seock-Ah</creator><creator>Kim, Tae-You</creator><creator>Kim, Sun-Whe</creator><creator>Bang, Yung-Jue</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20160314</creationdate><title>Survival Outcomes According to Adjuvant Treatment and Prognostic Factors Including Host Immune Markers in Patients with Curatively Resected Ampulla of Vater Cancer</title><author>Ha, Hye Rim ; Oh, Do-Youn ; Kim, Tae-Yong ; Lee, KyoungBun ; Kim, Kyubo ; Lee, Kyung-Hun ; Han, Sae-Won ; Chie, Eui Kyu ; Jang, Jin-Young ; Im, Seock-Ah ; Kim, Tae-You ; Kim, Sun-Whe ; Bang, Yung-Jue</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-1944e3d9fa5120d65de233f77993c25bda31b0b0af2b37c90e2203f2ce22e7ae3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adjuvant chemotherapy</topic><topic>Adjuvant therapy</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Ampulla of Vater</topic><topic>Ampulla of Vater - immunology</topic><topic>Ampulla of Vater - surgery</topic><topic>Analysis</topic><topic>Antigens</topic><topic>Biliary tract cancer</topic><topic>Biology and Life Sciences</topic><topic>Biomarkers, Tumor - metabolism</topic><topic>Cancer</topic><topic>Cancer therapies</topic><topic>Care and treatment</topic><topic>Chemotherapy</topic><topic>Chemotherapy, Adjuvant</topic><topic>Colorectal cancer</topic><topic>Common Bile Duct Neoplasms - drug therapy</topic><topic>Common Bile Duct Neoplasms - immunology</topic><topic>Common Bile Duct Neoplasms - surgery</topic><topic>Development and progression</topic><topic>Female</topic><topic>Gallbladder</topic><topic>Genetic aspects</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Immunity</topic><topic>Inflammation</topic><topic>Internal medicine</topic><topic>Laboratories</topic><topic>Liver cancer</topic><topic>Lymph nodes</topic><topic>Lymphatic system</topic><topic>Lymphocytes</topic><topic>Lymphocytes - immunology</topic><topic>Male</topic><topic>Medical prognosis</topic><topic>Medical research</topic><topic>Medical treatment</topic><topic>Medicine</topic><topic>Medicine and Health Sciences</topic><topic>Middle Aged</topic><topic>Multivariate analysis</topic><topic>Neoplasm Staging</topic><topic>Neutrophils - immunology</topic><topic>Oncology</topic><topic>Patients</topic><topic>Prognosis</topic><topic>Radiation therapy</topic><topic>Statistical analysis</topic><topic>Studies</topic><topic>Surgery</topic><topic>Survival</topic><topic>Survival Analysis</topic><topic>Systematic review</topic><topic>Treatment Outcome</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ha, Hye Rim</creatorcontrib><creatorcontrib>Oh, Do-Youn</creatorcontrib><creatorcontrib>Kim, Tae-Yong</creatorcontrib><creatorcontrib>Lee, KyoungBun</creatorcontrib><creatorcontrib>Kim, Kyubo</creatorcontrib><creatorcontrib>Lee, Kyung-Hun</creatorcontrib><creatorcontrib>Han, Sae-Won</creatorcontrib><creatorcontrib>Chie, Eui Kyu</creatorcontrib><creatorcontrib>Jang, Jin-Young</creatorcontrib><creatorcontrib>Im, Seock-Ah</creatorcontrib><creatorcontrib>Kim, Tae-You</creatorcontrib><creatorcontrib>Kim, Sun-Whe</creatorcontrib><creatorcontrib>Bang, Yung-Jue</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale In Context: Opposing Viewpoints</collection><collection>Gale In Context: Science</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Ecology Abstracts</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Meteorological & Geoastrophysical Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Agricultural Science Collection</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>ProQuest Public Health Database</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Materials Science & Engineering Collection</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>Agricultural & Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Materials Science Collection</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Materials Science Database</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Meteorological & Geoastrophysical Abstracts - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ha, Hye Rim</au><au>Oh, Do-Youn</au><au>Kim, Tae-Yong</au><au>Lee, KyoungBun</au><au>Kim, Kyubo</au><au>Lee, Kyung-Hun</au><au>Han, Sae-Won</au><au>Chie, Eui Kyu</au><au>Jang, Jin-Young</au><au>Im, Seock-Ah</au><au>Kim, Tae-You</au><au>Kim, Sun-Whe</au><au>Bang, Yung-Jue</au><au>Souglakos, John</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Survival Outcomes According to Adjuvant Treatment and Prognostic Factors Including Host Immune Markers in Patients with Curatively Resected Ampulla of Vater Cancer</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2016-03-14</date><risdate>2016</risdate><volume>11</volume><issue>3</issue><spage>e0151406</spage><epage>e0151406</epage><pages>e0151406-e0151406</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Ampulla of Vater cancer (AoV Ca) is a rare tumor, and its adjuvant treatment has not been established. The purpose of this study was to find out prognostic factors including host immunity and role of adjuvant treatment in AoV Ca.
We reviewed 227 AoV Ca patients with curative resection. Clinical characteristics, adjuvant treatment, disease-free survival (DFS) and overall survival (OS) were analyzed. Among all patients, 63.9, 36.1 and 33.9% had T1/T2, T3/T4 stage and lymph node-positive disease (LN+), respectively. OS of all patients was 90.9 months (95% CI: 52.9-129.0). OS was different according to neutrophil-to-lymphocyte ratio (HR 1.651, 95% CI: 1.11-2.47), platelet-to-lymphocyte ratio (HR 1.488, 95% CI: 1.00-2.21) and systemic inflammatory index (HR 1.669, 95% CI: 1.13-2.47). In multivariate analysis, adverse prognostic factors for OS included vascular invasion (HR 2.571, 95% CI: 1.20-5.53) and elevated CA 19-9 (HR 1.794, 95% CI: 1.07-3.05). A total of 104 patients (46.3%) received adjuvant treatment (25 out of 111of T1/T2 & LN (-), 79 out of 116 of T3/T4 or LN (+)). In T3/T4 or LN (+) stage, adjuvant CCRT with maintenance chemotherapy provided the longest OS (5-year OS rate: 47.0 vs. 41.4%).
Vascular invasion and elevated CA 19-9 were adverse prognostic factors in resected AoV Ca. In T3/T4 or LN (+) stage, adjuvant CCRT with maintenance chemotherapy provided the best survival outcome. Adjuvant treatment should be further defined in AoV Ca, especially with poor prognostic factors.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>26974670</pmid><doi>10.1371/journal.pone.0151406</doi><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2016-03, Vol.11 (3), p.e0151406-e0151406 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_1773263006 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Public Library of Science (PLoS); EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Adjuvant chemotherapy Adjuvant therapy Adult Aged Aged, 80 and over Ampulla of Vater Ampulla of Vater - immunology Ampulla of Vater - surgery Analysis Antigens Biliary tract cancer Biology and Life Sciences Biomarkers, Tumor - metabolism Cancer Cancer therapies Care and treatment Chemotherapy Chemotherapy, Adjuvant Colorectal cancer Common Bile Duct Neoplasms - drug therapy Common Bile Duct Neoplasms - immunology Common Bile Duct Neoplasms - surgery Development and progression Female Gallbladder Genetic aspects Hospitals Humans Immunity Inflammation Internal medicine Laboratories Liver cancer Lymph nodes Lymphatic system Lymphocytes Lymphocytes - immunology Male Medical prognosis Medical research Medical treatment Medicine Medicine and Health Sciences Middle Aged Multivariate analysis Neoplasm Staging Neutrophils - immunology Oncology Patients Prognosis Radiation therapy Statistical analysis Studies Surgery Survival Survival Analysis Systematic review Treatment Outcome Tumors |
| title | Survival Outcomes According to Adjuvant Treatment and Prognostic Factors Including Host Immune Markers in Patients with Curatively Resected Ampulla of Vater Cancer |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-21T11%3A33%3A20IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Survival%20Outcomes%20According%20to%20Adjuvant%20Treatment%20and%20Prognostic%20Factors%20Including%20Host%20Immune%20Markers%20in%20Patients%20with%20Curatively%20Resected%20Ampulla%20of%20Vater%20Cancer&rft.jtitle=PloS%20one&rft.au=Ha,%20Hye%20Rim&rft.date=2016-03-14&rft.volume=11&rft.issue=3&rft.spage=e0151406&rft.epage=e0151406&rft.pages=e0151406-e0151406&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0151406&rft_dat=%3Cgale_plos_%3EA453471402%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1773263006&rft_id=info:pmid/26974670&rft_galeid=A453471402&rft_doaj_id=oai_doaj_org_article_5a7a0e3a480b4665a5e5d9098fbca344&rfr_iscdi=true |