|Table of Contents|

Analysis of effect and prognostic factors of adjuvant chemotherapy in patients after radical surgery for duodenal cancer

Journal Of Modern Oncology[ISSN:1672-4992/CN:61-1415/R]

Issue:
2024 20
Page:
3906-3910
Research Field:
Publishing date:

Info

Title:
Analysis of effect and prognostic factors of adjuvant chemotherapy in patients after radical surgery for duodenal cancer
Author(s):
PAN Jun1; CHEN Yitian1; ZHANG Fei2; ZHANG Tianlong2; CHEN Ying3; CHU Xiaoyuan1
1.Department of Medical Oncology;2.Department of Laboratory,Cancer Center of PLA,Eastern Theater General Hospital of PLA,Jiangsu Nanjing 210002,China;3.Department of Gastroenterology,Shanghai Changhai Hospital,Naval Medical University,Shanghai 200433,China.
Keywords:
duodenal cancer; radical surgery; adjuvant chemotherapy; prognosis
PACS:
R735.3
DOI:
10.3969/j.issn.1672-4992.2024.20.016
Abstract:
Objective:To observe the effect of adjuvant chemotherapy on the prognosis of patients after radical surgery for duodenal cancer.Methods:The clinical data of 51 patients after radical surgery for duodenal cancer diagnosed by histopathology from September 2008 to December 2019 were collected.The Kaplan-Meier method was applied to draw the survival curve.The life table method was used to calculate the 1-year survival rate and the 3-year survival rate.The Log-rank test was performed for differences in survival,and the Cox proportional regression model was used for multivariate analysis.Results:Univariate analysis showed that T stage,lymph node metastasis,degree of differentiation,nerve invasion and adjuvant chemotherapy were all associated with the prognosis of patients after radical surgery for duodenal cancer(P＜0.05),and gender,age,size of tumor,jaundice and pancreatic invasion before surgery were not associated with the prognosis(P＞0.05).Multivariate analysis showed that adjuvant chemotherapy(HR=0.08,95%CI:0.022~0.291,P＜0.001) and lymph node metastasis(HR=2.768,95%CI:1.223~6.268,P=0.015) were the independent prognostic factors affecting the patients after radical duodenal cancer.Subgroup analysis showed that the prognosis of those with adjuvant chemotherapy was better than that of those without chemotherapy in patients with T1/T2 stage,no lymph node metastasis and moderately/well differentiated patients(P＜0.001).There was no significant difference in survival between the GEMOX regimen and the FOLFOX regimen(P＞0.05).Conclusion:Adjuvant chemotherapy is an independent prognostic factor for patients after radical surgery for duodenal cancer,and those without high-risk factors may also benefit from it.There is no significant survival difference between the FOLFOX regimen and the GEMOX regimen,and both may be an option,but the GEMOX regimen may have a potential survival advantage.

References:

［1］SIEGEL RL,MILLER KD,WAGLE NS,et al.Cancer statistics,2023［J］.CA Cancer J Clin,2023,73(1):17-48.
［2］KHOSLA D,DEY T,MADAN R,et al.Small bowel adenocarcinoma:an overview［J］.World J Gastrointest Oncol,2022,14(2):413-422.
［3］AYDIN D,KEFELI U,OZCELIK M,et al.The prognostic utility of the metastatic lymph node ratio and the number of regional lymph nodes removed from patients with small bowel adenocarcinomas［J］.Medicina (Kaunas),2023,59(8):1472.
［4］BHATT H,MATHIS KL.Small bowel carcinoma in the setting of inflammatory bowel disease［J］.Clin Colon Rectal Surg,2024,37(1):46-52.
［5］QIN T,ZHANG H,PAN S,et al.Effect of laparoscopic and open pancreaticoduodenectomy for pancreaticor periampullary tumors:three-year follow-up of a randomized clinical trial［J］.Ann Surg,2024,279(4):605-612.
［6］ZAANAN A,HENRIQUES J,TURPIN A,et al.Adjuvant chemotherapy benefit according to T and N stage in small bowel adenocarcinoma:a large retrospective multicenter study［J］.JNCI Cancer Spectr,2023,7(5):pkad064.
［7］HUFFMAN BM,JIN Z,YADAV S,et al.Novel prognostic factors in resected small bowel adenocarcinoma［J］.Clin Colorectal Cancer,2019,18(3):218-225.
［8］LEE TC,WIMA K,MORRIS MC,et al.Small bowel adenocarcinomas:impact of location on survival［J］.J Surg Res,2020,252:116-124.
［9］BENSON AB,VENOOK AP,AL-HAWARY MM,et al.Small bowel adenocarcinoma,Version 1.2020,NCCN clinical practice guidelines in oncology［J］.J Natl Compr Canc Netw,2019,17(9):1109-1133.
［10］VITIELLO F,CEREDA S,FOTI S,et al.Immunotherapy in small bowel adenocarcinoma:a potential role［J］.Immunol Med,2024,47(1):1-5.
［11］THIESSEN M,LEE-YING RM,MONZON JG,et al.An examination of lymph node sampling as a predictor of survival in resected node-negative small bowel adenocarcinoma:a SEER database analysis［J］.J Gastrointest Cancer,2020,51(1):280-288.
［12］LIU Z,LIU K,GAO J,et al.Prognostic value of lymph node evaluation in stage II small bowel adenocarcinoma:an updated analysis of surveillance,epidemiology,and end results database［J］.Front Oncol,2022,12:865745.
［13］ZHANG C,LIZALEK JM,DOUGHERTY C,et al.Neoadjuvant therapy for duodenal and ampullary adenocarcinoma:asystematic review［J］.Ann Surg Oncol,2024,31(2):792-803.
［14］潘军,秦叔逵,杨宁蓉,等.晚期十二指肠癌患者一线化疗的临床疗效及预后因素分析［J］.临床肿瘤学杂志,2018,23(01):44-51. PAN J,QIN SK,YANG NR,et al.Cox regression analysis of prognosis and clinical observation of first-line chemotherapy in advanced duodenal cancer［J］.Chinese Clinical Oncology,2018,23(01):44-51.
［15］CEN P,WRAY CJ,ZHANG S,et al.Durable response for ampullary and duodenal adenocarcinoma with a nab-paclitaxel plus gemcitabine +/-cisplatin combination［J］.Cancer Med,2019,8(7):3464-3470.
［16］PARK SJ,SHIN K,HONG TH,et al.Histologic subtype-based evaluation of recurrence and survival outcomes in patients with adenocarcinoma of the ampulla of vater［J］.Sci Rep,2023,13(1):16547.
［17］BYRLING J,GHAZI S,ANDERSSON B.Tumour origin,diagnostic accuracy and histopathological evaluation in patients with periampullary cancer:nationwide cohort study［J］.BJS Open,2023,7(5):zrad104.
［18］MOEKOTTE AL,MALLEO G,VAN ROESSEL S,et al.Gemcitabine-based adjuvant chemotherapy in subtypes of ampullary adenocarcinoma:international propensity score-matched cohort study［J］.Br J Surg,2020,107(9):1171-1182.
［19］RAMASWAMY A,BHANDARE M,BAL M,et al.Clinico-pathological correlates and survival outcomes in 214 resected ampullary adenocarcinomas-are outcomes different in intestinal and pancreatobiliary subtypes with adjuvant gemcitabine［J］.HPB (Oxford),2020,22(3):376-382.
［20］潘军,王琳,杨宁蓉.晚期十二指肠癌肝转移一线化疗方案的临床观察［J］.现代肿瘤医学,2018,26(16):2568-2572. PAN J,WANG L,YANG NR.Clinical observation of first-line chemotherapy in advanced duodenal cancer with liver metastasis［J］.Modern Oncology,2018,26(16):2568-2572.

Memo

Memo:
CSCO-豪森肿瘤研究基金（编号：Y-HS2017-066）；吴阶平医学基金（编号：320.6750.2022-18-51）
Last Update: 1900-01-01