Ampulla of Vater carcinoma in real-world clinical practice: a case series

Tumori. 2015 Jun 25;101(3):e75-8. doi: 10.5301/tj.5000267.

Abstract

Aims and background: The aim of this report was to describe the way in which a rare and niche disease like ampulla of Vater carcinoma (AVC) was treated in real-world clinical practice.

Methods and study design: A retrospective analysis of consecutive patients with a diagnosis of AVC treated at our medical oncology unit between August 2004 and August 2013 was performed.

Results: We evaluated 8 consecutive patients with a median age of 60 years (range 56-84). At the last follow-up, 4 patients were alive without evidence of disease and 4 patients had died. The median follow-up time was 21.51 months (range 1-100.43), the median overall survival 23.19 months (range 7.07-102.2), and the median disease-free survival 18.26 months (range 0-102.2). Six patients underwent surgery, which consisted of pylorus-preserving pancreaticoduodenectomy, R0 in all cases. Tumor histology was adenocarcinoma in all patients. Two patients presented with locally advanced disease. Only 1 patient presented with metastases while 3 patients subsequently developed metastases. Two patients received chemotherapy for metastatic disease; in both cases disease progression was observed at the first disease evaluation.

Conclusions: We can consider AVC as a pathology niche and pancreaticoduodenectomy as the effective treatment for these patients.

MeSH terms

  • Adult
  • Aged
  • Ampulla of Vater*
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Camptothecin / administration & dosage
  • Camptothecin / analogs & derivatives
  • Capecitabine
  • Carcinoma / diagnosis*
  • Carcinoma / therapy*
  • Common Bile Duct Neoplasms / diagnosis*
  • Common Bile Duct Neoplasms / therapy*
  • Deoxycytidine / administration & dosage
  • Deoxycytidine / analogs & derivatives
  • Disease-Free Survival
  • Female
  • Fluorouracil / administration & dosage
  • Fluorouracil / analogs & derivatives
  • Follow-Up Studies
  • Gemcitabine
  • Humans
  • Irinotecan
  • Kaplan-Meier Estimate
  • Leucovorin / administration & dosage
  • Male
  • Middle Aged
  • Neoadjuvant Therapy / methods*
  • Organ Sparing Treatments
  • Organoplatinum Compounds / administration & dosage
  • Pancreaticoduodenectomy*
  • Pylorus
  • Retrospective Studies
  • Treatment Outcome

Substances

  • Organoplatinum Compounds
  • Deoxycytidine
  • Capecitabine
  • Irinotecan
  • Leucovorin
  • Fluorouracil
  • Camptothecin
  • Gemcitabine

Supplementary concepts

  • Folfox protocol