Evidence map›Paper›PMID 32849944›Full record

ArticleJournal of clinical medicine research2020

The Clinical Benefit of Adjuvant Therapy in Long-Term Survival of Early-Stage Ampullary Carcinoma: A Single Institutional Experience.

Ashish Manne, Haris Hatic, Peng Li, Rojymon Jacob, Grant Williams, Ravi Paluri

Open access · diamondAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of clinical medicine research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
0.4field-weighted citation impact, top 36% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 8 citations in OpenAlex.

  1. Role of Radiation Therapy for Biliary Tract Cancers.Current oncology (Toronto, Ont.) · 2025
    Review
  2. Article
  3. Article
  4. [Treatment of Ampullary Adenocarcinoma].The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi · 2023
    Review
  5. Article
  6. Review
  7. Treatment Approach to Adenocarcinoma of the Ampulla of Vater.Current treatment options in oncology · 2021
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 1 country.

Ashish ManneDivision of Medical Oncology, Department of Internal Medicine, The Ohio State University, Columbus, OH, USA.
Haris HaticDepartment of Hematology & Oncology, University of Alabama, Birmingham, AL, USA.
Peng LiDepartment of Hematology & Oncology, University of Alabama, Birmingham, AL, USA.
Rojymon JacobDepartment of Radiation Oncology, University of Alabama, Birmingham, AL, USA.
Grant WilliamsDepartment of Hematology & Oncology, University of Alabama, Birmingham, AL, USA.
Ravi PaluriDepartment of Hematology & Oncology, University of Alabama, Birmingham, AL, USA.
University of Alabama at Birmingham · USThe Ohio State University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe role of adjuvant chemotherapy (CT) or combination chemoradiation (CRT) remains uncertain for ampullary carcinoma (AC). In this analysis, we reviewed our institution's experience with early-stage AC.

methodsAC patients who had definitive surgical intervention at the University of Alabama, Birmingham, between 2005 and 2015, were identified. Clinicopathologic factors and disease statuses were obtained from chart review. The univariate Cox proportional hazard model was conducted for evaluating the parameters associated with overall survival (OS). Kaplan-Meier method and log-rank method were used to compare the time-to-events. We estimated the survival for the patients who had definitive surgery (pancreaticoduodenectomy (PD) or ampullectomy), and followed them up with assessing the influence of adjuvant treatment (chemoradiotherapy or CT) alone on the survival in the early-stage (stage I/II) AC.

resultsA total of 63 patients had definitive surgery. The median OS and progression-free survival (PFS) for all the patients who had definitive surgery were 40.5 months and 28 months, respectively. Adjuvant treatment was administered in 60% of patients with early-stage (stage I/II) AC (CT 36% and CRT 24%), while 22% were on surveillance post surgery. The pathological stage ≥ 2, Lymph node (LN) metastasis, peri-nodal extension (PNE) and peri-pancreatic extension (PPE) were found to be the determinants for poor OS and PFS by univariate analysis. Multiple Cox regression of these variables showed a significant influence of PPE and pathological staging on the OS and PFS, respectively. In the early-stage AC with no high-risk features, adjuvant therapy did not improve the survival over surgery alone (40.5 vs. 51.7 months, P = 0.93). The addition of radiation to CT did not yield improved outcome in early-stage cancers. For CRT and CT, OS was 22.8 versus 65.7 months (P = 0.3975), and PFS was 25.3 versus 65.7 months (P = 0.4699).

conclusionsIn the early-stage AC, adjuvant therapy may not improve the outcome in the short term but may benefit over a long period. It should be considered, especially in patients with adverse risk factors. Radiation therapy may not be useful in managing AC in the adjuvant setting.

Indexed as

Adjuvant treatmentAdverse factors for ampullary cancerAmpullary cancerCancer of ampulla of VaterEarly-stage ampullary cancerPeri-ampullary cancerPost-operative management of ampullary cancer

Identifiers

PMID32849944
PMCPMC7430918
OpenAlexW3049544371

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.