Survival following partial pancreatectomy and radiation for ampullary adenocarcinoma

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15614 Background: AA remains a relatively rare cancer with limited information regarding optimal management. Very few series of AA treated with postoperative CRT have been reported. This retrospective study reports the outcomes of adjuvant chemotherapy and radiation therapy from a single institution. Patients and Methods: We identified 20 patients with AA who completed a course of 5FU based postoperative chemoradiation at the Hospital of the University of Pennsylvania between 1989 and 2005. All patients underwent a Whipple-style partial pancreatectomy prior to radiation, of which 14 had a pylorus-preserving procedure. All patients treated had either pathologic T3, T4, or N1 involvement, or microscopically positive margins. There were no patients with gross residual or metastatic disease. 5FU-based CRT was delivered to the surgical bed and regional nodes with a mean dose of 49.5 Gy (range 43.2 to 59.4). The median age at completion of radiation was 63 years (range 43-78). Survival was calculated by Kaplan-Meier actuarial analysis. Results: Median follow-up is 1.2 years (range: 0.2-9.9 years). Actuarial survival at 1, 2, and 3 years was 56%, 51%, and 39% respectively with 11, 10, and 6 patients evaluable at those time points. There were 3 patients with pT4 and 11 with pT3 involvement. Fifteen had positive nodes on with a median of 14 nodes sampled. Three patients had microscopically positive margins. Conclusions: This series contributes additional data to the limited literature available on outcomes for ampullary carcinoma following resection and chemoradiation. Pts with ampullary carcinoma have a favorable outcome compared to pancreatic and biliary carcinomas. Postoperative chemotherapy and radiation therapy should be considered for high risk disease. No significant financial relationships to disclose.

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