Combined treatment for cancer of the ampulla of Vater

Aim: comparative study of the immediate and long-term results of combined treatment of patients with pancreatobiliary cancer of the ampulla of Vater. 

Materials and methods. From 2001 to 2019 21 patients with pancreatobiliary cancer of the ampulla of Vater underwent curative treatment. It included preoperative radiotherapy, extended Wipple procedure and adjuvant chemotherapy as indicated (main group). In 48 cases of pancreatobiliary cancer of the ampulla of Vater extended Wipple procedure and adjuvant chemotherapy according to indications was performed (comparison group). In 43 cases of intestinal cancer of the ampulla of Vater extended Wipple procedure and adjuvant chemotherapy according to indications was performed.

Results. Postoperative complication and mortality in the study group and the comparison group were 14.3% and 35.4% (p = 0.07), 4.8% and 6.3% (p = 0.8). Overall 5-year survival rate, median survival were 50.7% and 9.8% (p = 0.01), 51 (36.5–115) mo. and 10 (4–29) mo. (p = 0.0008). Overall 5-year survival rate, median survival in the group of intestinal cancer of the ampulla of Vater accounted for 61.3 % and 44 (17–85.5) mo. One-year disease-free survival in patients with adenocarcinoma of the ampulla of Vater who have undergone curative treatment was 77.8%, 3-year survival – 51.0%, 5-year survival – 35.2%, median is 22 (9–54) mo.

Conclusion. Preoperative radiotherapy in curative treatment of pancreatobiliary cancer of the ampulla of Vater did not result to a change in the nature and an increase in the postoperative complications rate.

Combination treatment for pancreatobiliary cancer of the ampulla of Vater significantly improved long-term survival.

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