Patterns of failure for stage I ampulla of Vater adenocarcinoma: A single institutional experience

Jim Zhong, Manisha Palta, Christopher G. Willett, Shannon J. McCall, Frances McSherry, Douglas S. Tyler, Hope E. Uronis, Brian G. Czito

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


Background: Ampullary adenocarcinoma is a rare malignancy associated with a relatively favorable prognosis. Given high survival rates in stage I patients reported in small series with surgery alone, adjuvant chemoradiotherapy (CRT) has traditionally been recommended only for patients with high risk disease. Recent population-based data have demonstrated inferior outcomes to previous series. We examined disease-related outcomes for stage I tumors treated with pancreaticoduodenectomy, with and without CRT. Methods: All patients with stage I ampullary adenocarcinoma treated from 1976 to 2011 at Duke University were reviewed. Disease-related endpoints including local control (LC), metastasis-free survival (MFS), disease-free survival (DFS) and overall survival (OS) were analyzed using the Kaplan-Meier method. Results: Forty-four patients were included in this study. Thirty-one patients underwent surgery alone, while 13 also received adjuvant CRT. Five-year LC, MFS, DFS and OS for patients treated with surgery only and surgery with CRT were 56% and 83% (P=0.13), 67% and 83% (P=0.31), 56% and 83% (P=0.13), and 53% and 68% (P=0.09), respectively. Conclusions: The prognosis for patients diagnosed with stage I ampullary adenocarcinoma may not be as favorable as previously described. Our data suggests a possible benefit of adjuvant CRT delivery.

Original languageEnglish (US)
Pages (from-to)421-427
Number of pages7
JournalJournal of Gastrointestinal Oncology
Issue number6
StatePublished - 2014
Externally publishedYes


  • Adjuvant therapy
  • Ampulla of Vater
  • Patterns of failure

ASJC Scopus subject areas

  • Oncology
  • Gastroenterology


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