Adjuvant Therapy May Not Improve Survival

Ampullary cancer originates where the pancreatic and bile ducts meet in the ampulla of Vater and discharge contents into the small intestine bile ducts often get blocked leading to the eyes and skin becoming jaundiced due to accumulation of bile within the body. These signs are obvious and mean that these cancers are often caught early and easier to treat.

Researchers analyzed  the American College of Surgeons National Cancer Database to identify  5398 patients with stage one to three ampullary tumors that had been surgically removed and compared 316 patients receiving surgery along with chemotherapy, 1197 patients receiving radiation therapy and chemotherapy, and 3785 patients receiving only surgery. Variables were taken into consideration to produce overall survival rates in patients during analyses. 1513 patients who had surgical removal of their ampullary tumors received adjuvant therapy during the study period, of which researchers were not able to find any significant differences in stage specific survival between patients receiving any treatment at stages one to three of the disease, and no survival benefit was found for patients with positive margins or cancer in lymph nodes receiving adjuvant therapy.

Lack of randomized clinical trials leaves the role that adjuvant therapy plays for patients with surgical removal of ampullary tumor not clearly defined. Analysis of this database shows a need to reassess treatment for patients with these kinds of tumors, which may even include removal of prescribed adjuvant therapy, as this study does not show any survival benefit even when used in patients with aggressive form of disease. It is hoped that results of this study may lead to new standards of patient care regardless of the stage of disease which will improve quality of life for patients with metastatic ampullary cancer.