Combination therapy of resection and intraoperative radiation for patients with carcinomas of extrahepatic bile duct and ampulla of Vater: prognostic advantage over resection alone?
OBJECTIVE
To investigate the therapeutic efficacy of intraoperative radiation for carcinomas of the bile duct and ampulla of Vater.


METHODS
Postoperative morbidity, mortality and survival of patients undergoing surgical resection of ampullary cancer (n = 19) and bile duct cancer (n = 28) were retrospectively compared between two groups with and without intraoperative radiation.


RESULTS
Background items (age, gender, preoperative laboratory data, operative time and bleeding volume, tumor stage) did not differ significantly between the two groups. The predominant postoperative complication was leakage of pancreatic juice, which occurred in similar rates in both groups. No significant differences were noted in the 3-year survival rates between the resection plus intraoperative radiation group and resection alone group (60.0% (n = 5) vs. 50.1% (n = 13) for ampullary cancer; 0% (n = 4) vs. 27.1% (n = 24) for bile duct cancer, respectively). The main causes of recurrence were distant metastasis for ampullary cancer and microscopic residue of carcinoma for bile duct cancer.


CONCLUSIONS
The combination of intraoperative radiation and resection may add no significant benefit to patients with ampullary and bile duct cancer when compared with resection alone.
Nakano
Kenji
K
Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan. kenji-n@med.kyushu-u.ac.jp
Chijiiwa
Kazuo
K
Toyonaga
Takayuki
T
Ueda
Junji
J
Takamatsu
Yuji
Y
Kimura
Masahiko
M
Nakamura
Katsumasa
K
Yamaguchi
Koji
K
Tanaka
Masao
M
D000368:Aged; D014670:Ampulla of Vater; D001650:Bile Duct Neoplasms / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D017734:Bile Ducts, Extrahepatic; D002423:Cause of Death; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D016577:Pancreaticoduodenectomy; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome