Survival benefit of adjuvant treatment for ampullary cancer with lymph nodal involvement:A systematic review and meta-analysis  

作　　者：Min Kyu Kim Jin Ho Choi In Rae Cho Sang Hyub Lee Ji Kon Ryu Yong-Tae Kim Woo Hyun Paik 

机构地区：[1]Department of Gastroenterology,Asan Medical Center,University of Ulsan College of Medicine,Seoul,Korea [2]Department of Internal Medicine,Liver Research Institute,Seoul National University Hospital,Seoul National University College of Medicine,Seoul,Korea

出　　处：《Hepatobiliary & Pancreatic Diseases International》2024年第6期559-565,共7页国际肝胆胰疾病杂志（英文版）

摘　　要：Background:The efficacy of adjuvant treatment(AT)in ampullary cancer(AmC)remains controversial.This systematic review and meta-analysis aimed to evaluate the role of AT for AmC.Data sources:A comprehensive systematic search was performed in PubMed,EMBASE,Cochrane Library,and Web of Science databases.Studies comparing overall survival(OS)and recurrence-free survival(RFS)of patients who underwent AT or not following AmC resection were included.Results:A total of 3971 patients in 21 studies were analyzed.Overall pooled data showed no significant difference in effect on the OS by AT[hazard ratio(HR)=0.998,95%confidence interval(CI):0.768–1.297].No significant difference in recurrence between the AT and non-AT(nAT)groups was noted(HR=1.158,95%CI:0.764–1.755).In subgroup analysis,patients who received AT showed favorable outcomes in the OS compared with those who received nAT in nodal-positive AmC(HR=0.627,95%CI:0.451–0.870).Neither AT consisted of adjuvant chemotherapy with radiotherapy(HR=0.804,95%CI:0.563–1.149)nor AT with adjuvant chemotherapy(HR=0.883,95%CI:0.642–1.214)showed any significant effect on the OS.Conclusions:The effect of AT in AmC on survival and recurrence did not show a significant benefit.Furthermore,effectiveness according to AT strategies did not show enhancement in survival.AT had an advantage in survival compared with nAT strategy in nodal-positive AmC.In cases of AmC with positive lymph nodal involvement,AT may be warranted regardless of detailed strategies.

关 键 词：Ampulla of Vater Adjuvant chemotherapy Adjuvant chemoradiotherapy META-ANALYSIS 

分 类 号：R735.0[医药卫生—肿瘤]