- 5-FU-based adjuvant therapy is associated with better survival than gemcitabine-based regimens in all immunohistochemical subtypes of ampullary adenocarcinoma.
Why this matters
- The findings suggest 5-FU may be a potential first-line therapy in advanced disease, with gemcitabine secondary if 5-FU is not well tolerated.
- Retrospective analysis (n=121; 32% intestinal, 48% pancreatobiliary, 20% ambiguous).
- Funding: None disclosed.
- 39% of patients received adjuvant chemotherapy: 27% gemcitabine-based, 12% 5-FU-based.
- Median survival:
- Intestinal, 45.6 (95% CI, 21.4-104.3) months.
- Pancreatobiliary, 31.3 (95% CI, 23.9-40.4) months.
- Ambiguous, 46.9 (95% CI, 23.5-87.4) months.
- Adjuvant chemotherapy was associated with longer survival (45.6 vs 32.1 months; P=.032).
- Adjuvant chemotherapy with 5-FU was associated with longer survival (87.4 [95% CI, 40.4 to not reached] months) than gemcitabine (38 [95% CI, 23.57 to not reached] months) and no treatment (32.1 [95% CI, 23.5-46.9] months).
- Multivariable analysis showed that treatment with 5-FU was an independent predictor of better survival (HR, 0.24; P=.031).
- Receipt of gemcitabine-based adjuvant chemotherapy was not associated with survival.
- Adjuvant chemotherapy was associated with better survival in stage IIB and III diseases (38.6 vs 21.43 months; P<.01 but not in early-stage disease.>
- Retrospective analysis.