title: Treatment utilization and surgical outcome of ampullary and duodenal adenocarcinoma.
abstract: BACKGROUND
  Ampullary (AMP-A) and duodenal adenocarcinomas (DA) are rare tumors. The literature regarding treatment and outcome is very limited. The objective of this project is to compare the outcomes of AMP-A and DA.
  
  
  METHODS
  The records for AMP-A and DA patients between July 1995 and July 2012 at Emory University were reviewed for demographics, pathology, treatment, and survival. Survival rates were estimated by Kaplan-Meier method and compared with log-rank test. A Cox proportional hazard model was fitted to estimate the adjusted effect of AMP-A versus DA on overall survival (OS).
  
  
  RESULTS
  Ninety-five AMP-A and 66 DA patients were identified. No significant difference between patients with DA and AMP-A was observed for age, gender, or grade. DA presented with larger tumors and higher stages. Treatment included surgery, surgery followed by adjuvant therapy or chemotherapy alone. No OS difference was observed when controlled for stage. AMP-A was sub-classified into intestinal (IAMP), pancreaticobiliary (PBAMP), and unspecified types. IAMP tended to present at a higher grade (P = 0.045) than PBAMP. No OS difference between the IAMP and PBAMP was observed.
  
  
  CONCLUSIONS
  After accounting for stage, OS was not significantly different for AMP-A and DA patients. There was no OS difference comparing PBAMP with IAMP.
authors: Department of Hematology and Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia.
authors: Walid L
authors: WL
authors: Shaib
authors: Rahul
authors: R
authors: Sharma
authors: Edith
authors: E
authors: Brutcher
authors: Sungjin
authors: S
authors: Kim
authors: Shishir K
authors: SK
authors: Maithel
authors: Zhengjia
authors: Z
authors: Chen
authors: David A
authors: DA
authors: Kooby
authors: John
authors: J
authors: Kauh
authors: Jerome
authors: J
authors: Landry
authors: Bassel F
authors: BF
authors: El-Rayes
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014670:Ampulla of Vater / Q000473:pathology / Q000601:surgery; D017024:Chemotherapy, Adjuvant / Q000706:statistics & numerical data; D003138:Common Bile Duct Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D004379:Duodenal Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D060787:Neoplasm Grading; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D010524:Peripheral Nervous System Neoplasms / Q000473:pathology; D016016:Proportional Hazards Models; D044469:Racial Groups / Q000706:statistics & numerical data; D018714:Radiotherapy, Adjuvant / Q000706:statistics & numerical data; D012189:Retrospective Studies; D019043:Vascular Neoplasms / Q000473:pathology
keywords: adenocarcinoma; ampullary; ampullary subtypes; duodenal; survival