Periampullary adenocarcinoma
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| Section editor | |
|---|---|
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Eric I. Marks, MD Boston University Boston, MA, USA |
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Note: there is some overlap, especially in the earlier literature, between treatment regimens for periampullary adenocarcinoma and those for pancreatic adenocarcinoma, cholangiocarcinoma, and gallbladder cancer; please see those pages for additional regimens.
Guidelines
Given the rapid change in evidence in many areas of hematology/oncology, readers are encouraged to consider any guideline published 5+ years ago to be for historical purposes, only.
ESMO
- 2016: Biliary cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. PubMed
NCCN
- NCCN Guidelines - Ampullary Adenocarcinoma
- 2023: Chiorean et al. Ampullary Adenocarcinoma, Version 1.2023, NCCN Clinical Practice Guidelines in Oncology. PubMed
Adjuvant therapy
Observation
Regimen
| Study | Dates of enrollment | Evidence | Comparator | Comparative Efficacy |
|---|---|---|---|---|
| Takada et al. 2002 | 1986-1992 | Phase 3 (C) | 5-FU & Mitomycin | Did not meet primary endpoint of OS |
| Neoptolemos et al. 2012 (ESPAC-3) | 2000-2008 | Phase 3 (C) | 1. FULV 2. Gemcitabine |
Did not meet primary endpoint of OS |
No adjuvant therapy.
Preceding treatment
References
- Takada T, Amano H, Yasuda H, Nimura Y, Matsushiro T, Kato H, Nagakawa T, Nakayama T; Study Group of Surgical Adjuvant Therapy for Carcinomas of the Pancreas and Biliary Tract. Is postoperative adjuvant chemotherapy useful for gallbladder carcinoma? A phase III multicenter prospective randomized controlled trial in patients with resected pancreaticobiliary carcinoma. Cancer. 2002 Oct 15;95(8):1685-95. link to original article PubMed
- ESPAC-3: Neoptolemos JP, Moore MJ, Cox TF, Valle JW, Palmer DH, McDonald AC, Carter R, Tebbutt NC, Dervenis C, Smith D, Glimelius B, Charnley RM, Lacaine F, Scarfe AG, Middleton MR, Anthoney A, Ghaneh P, Halloran CM, Lerch MM, Oláh A, Rawcliffe CL, Verbeke CS, Campbell F, Büchler MW; European Study Group for Pancreatic Cancer. Effect of adjuvant chemotherapy with fluorouracil plus folinic acid or gemcitabine vs observation on survival in patients with resected periampullary adenocarcinoma: the ESPAC-3 periampullary cancer randomized trial. JAMA. 2012 Jul 11;308(2):147-56. Erratum in: JAMA. 2012 Nov 14;308(18):1861. link to original article PubMed NCT00058201