Trends in incidence and management of cancer of the ampulla of Vater

Rostain, Florian; Hamza, S.; Drouillard, Antoine; Faivre, Jean; Bouvier, Anne–Marie; Lepage, Côme

doi:10.3748/wjg.v20.i29.10144

Cited by 57 publications

(58 citation statements)

References 28 publications

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“…The present study assessed the clinicopathologic characteristics and survival rates according to stage of both eastern and western patients with AoV cancer. Although previous studies have reported 5‐year OS rates of 40–60%, those studies reported findings from single institution or countries . In contrast, we collected data from two institutions, SNUH in Korea and JHMI in the USA.…”

Section: Discussionmentioning

confidence: 99%

“…However, previously reported prognosis of patients with AoV cancer was relatively poor and heterogeneous, raising questions about the accuracy of data, especially information in the Surveillance, Epidemiology and End Results (SEER) database . Moreover, there is limited information about stage distribution and prognosis based on ethnicity and geography .…”

Section: Introductionmentioning

confidence: 99%

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Proposed new staging system for ampulla of Vater cancer with greater discriminatory ability: multinational study from eastern and western centers

Kim

Lee

et al. 2017

J Hepato Biliary Pancreat

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Proposed new staging system for ampulla of Vater cancer with greater discriminatory ability: multinational study from eastern and western centers

Kim

Lee

et al. 2017

J Hepato Biliary Pancreat

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“…4 As a result, AAC is more likely to be resectable at the time of diagnosis and resection rates of AAC are reportedly higher as compared to other periampullary cancers (50% vs 10%). 5,6 In addition, patients with ampullary cancer tend to have a better prognosis with 5-year survival rates of 30 -70% after resection. 1,[6][7][8][9][10] This broad range of survival could be explained by the morphological heterogeneity in AAC, which complicates the prediction of individual prognosis and clinical decision making with regard to adjuvant therapy.…”

Section: Introductionmentioning

confidence: 99%

“…5,6 In addition, patients with ampullary cancer tend to have a better prognosis with 5-year survival rates of 30 -70% after resection. 1,[6][7][8][9][10] This broad range of survival could be explained by the morphological heterogeneity in AAC, which complicates the prediction of individual prognosis and clinical decision making with regard to adjuvant therapy. Because of the anatomical confluence of three structures (duodenum, pancreatic and common bile duct), different histopathologic subtypes have been identified in AAC, based on the epithelium of their origin; intestinal, pancreaticobiliary or a mixed type.…”

Section: Introductionmentioning

confidence: 99%

Histopathologic Predictors of Survival and Recurrence in Resected Ampullary Adenocarcinoma

et al. 2019

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Disclosure of conflict: none declared. Word count: 3012Running head: Oncological outcome in ampullary cancer. STRUCTURED ABSTRACTObjective The aim of the study was to define histopathologic characteristics that independently predict overall survival (OS) and disease-free survival (DFS), in patients who underwent resection of an ampullary adenocarcinoma (AAC) with curative intent. Summary background dataA broad range of survival rates have been described for adenocarcinoma of the ampulla of Vater, presumably due to morphological heterogeneity which is a result of the different epitheliums AAC can arise from (intestinal or pancreaticobiliary). Large series with homogenous patient selection are scarce. Methods A retrospective multicenter cohort analysis of patients who underwent pancreatoduodenectomy for ampullary adenocarcinoma in nine European tertiary referral centers between February 2006 and December 2017, was performed. Collected data included demographics, histopathologic details, survival and recurrence. OS and DFS analyses were performed using Kaplan-Meier curves and Cox proportional hazard models. Results Overall, 887 patients were included, with a mean age of 66 ± 10 years. The median OS was 64 months with 1-, 3-, 5-and 10-year OS rates of 89%, 63%, 52% and 37%, respectively. Histopathologic subtype, differentiation grade, lymphovascular invasion, perineural invasion, T-stage, N-stage, resection margin and adjuvant chemotherapy were correlated with OS and DFS. N-stage (HR=3.30 [2.09 -5.21]), perineural invasion (HR=1.50 [1.01 -2.23]) and adjuvant chemotherapy (HR=0.69 [0.48 -0.97]) were independent predictors of OS in multivariable analysis, whereas DFS was only adversely predicted by N-stage (HR=2.65 [1.65 -4.27]).Conclusions Independent predictors of OS in resected ampullary cancer were N-stage, perineural invasion and adjuvant chemotherapy. N-stage was the only predictor of DFS. These findings improve predicting survival and recurrence after resection of ampullary adenocarcinoma.

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“…PDAC is the fourth most common cause of cancer death in Europe (Ferlay et al , 2010; Rostain et al , 2014; Ryan et al , 2014; Malvezzi et al , 2016; Siegel et al , 2016). …”

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confidence: 99%

Stroma-regulated HMGA2 is an independent prognostic marker in PDAC and AAC

et al. 2017

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Background:The HMGA2 protein has experimentally been linked to EMT and cancer stemness. Recent studies imply that tumour–stroma interactions regulate these features and thereby contribute to tumour aggressiveness.Methods:We analysed 253 cases of pancreatic ductal adenocarcinoma (PDAC) and 155 cases of ampullary adenocarcinoma (AAC) for HMGA2 expression by IHC. The data were correlated with stroma abundance and supplemented by experimental studies.Results:HMGA2 acts as an independent prognostic marker associated with a significantly shorter overall survival in both tumour types. Overall, HMGA2-positivity was more frequent in patients with PDAC than with AAC. The HMGA2 status in tumour cells significantly correlated with the abundance of PDGFRβ-defined stroma cells. In vivo co-injection of Panc-1 cancer cells with pancreatic stellate cells increased tumour growth in a manner associated with increased HMGA2 expression. Furthermore, in vitro treatment of Panc-1 with conditioned media from PDGF-BB-activated stellate cells increased their ability to form tumour spheroids.Conclusions:This study identifies HMGA2 expression in tumour cells as an independent prognostic marker in PDAC and AAC. Correlative data analysis gives novel tissue-based evidence for a heterotypic cross-talk with stroma cells as a possible mechanism for HMGA2 induction, which is further supported by experimental models.

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Trends in incidence and management of cancer of the ampulla of Vater

Abstract: Cancer of the ampulla of Vater is still uncommon, but its incidence increased for men in Burgundy. Diagnosis is often made at an advanced stage, dramatically worsening the prognosis.

Cited by 57 publications

References 28 publications

Proposed new staging system for ampulla of Vater cancer with greater discriminatory ability: multinational study from eastern and western centers

Proposed new staging system for ampulla of Vater cancer with greater discriminatory ability: multinational study from eastern and western centers

Histopathologic Predictors of Survival and Recurrence in Resected Ampullary Adenocarcinoma

Stroma-regulated HMGA2 is an independent prognostic marker in PDAC and AAC

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