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Yungjue Bang - One of the best experts on this subject based on the ideXlab platform.

  • role of adjuvant chemoradiotherapy for Ampulla of Vater cancer
    International Journal of Radiation Oncology Biology Physics, 2009
    Co-Authors: Kyubo Kim, Eui Kyu Chie, Jinyoung Jang, Sun Whe Kim, Taeyou Kim, Yungjue Bang
    Abstract:

    Purpose To evaluate the role of adjuvant chemoradiotherapy for Ampulla of Vater cancer. Methods and Materials Between January 1991 and December 2002, 118 patients with Ampulla of Vater cancer underwent en bloc resection. Forty-one patients received adjuvant chemoradiotherapy [RT(+) group], and 77 did not [RT(-) group]. Postoperative radiotherapy was delivered to the tumor bed and regional lymph nodes, for a total dose of up to 40 Gy delivered in 2-Gy fractions, with a planned 2-week rest period halfway through the treatment period. Intravenous 5-fluorouracil (500 mg/m 2 /day) was given on Days 1 to 3 of each split course. The median follow-up was 65 months. Results The 5-year overall survival rate in the RT(-) and RT(+) groups was 66.9% and 52.8%, respectively ( p = 0.2225). The 5-year locoregional relapse–free survival rate in the RT(-) and RT(+) groups was 79.9% and 80.2%, respectively ( p = 0.9582). When age, type of operation, T stage, N stage, histologic differentiation, and the use of adjuvant chemoradiotherapy were incorporated into the Cox proportional hazard model, there was an improvement in the locoregional relapse–free survival rate ( p = 0.0050) and a trend toward a longer overall survival ( p = 0.0762) associated with the use of adjuvant chemoradiotherapy. Improved overall survival ( p = 0.0235) and locoregional relapse–free survival ( p = 0.0095) were also evident in patients with nodal metastasis. In contrast, enhanced locoregional control ( p = 0.0319) did not result in longer survival in patients with locally advanced disease ( p = 0.4544). Conclusions Adjuvant chemoradiotherapy may enhance locoregional control and overall survival in patients with Ampulla of Vater cancer after curative resection, especially in those with nodal involvement.

Jong Chul Rhee - One of the best experts on this subject based on the ideXlab platform.

  • Can endoscopic resection be applied for early stage Ampulla of Vater cancer
    Gastrointestinal endoscopy, 2006
    Co-Authors: Sun-young Lee, Seong Ho Choi, Jin Seok Heo, Kee-taek Jang, Kyu Taek Lee, Jong Kyun Lee, Seung Woon Paik, Jong Chul Rhee
    Abstract:

    Background Although endoscopic resection can provide a wide tumor resection with a negative resection margin, it is not yet recommended as a curative therapy for Ampulla of Vater cancer. Methods To investigate the microinvasion rate and the diagnostic accuracy of endoscopic biopsy to properly judge the safety of endoscopic resection for Ampulla of Vater cancer. Design Single-center, retrospective study. Setting Academic medical center. Patients One hundred fifty-nine patients who were finally diagnosed with Ampulla of Vater cancer after curative surgical resection. Interventions We surveyed the pathologic concordance rate of endoscopic biopsy and the surgical pathology. For the 36 early stage (Tis or T1) cancers, we surveyed the presence of microlymphovascular invasion, gross appearance (intra-Ampullary type, periAmpullary type, or mixed type), and pathologic subtype (intestinal type or pancreaticobiliary type). Main Outcome Measurements Presence of microinvasion in early staged Ampulla of Vater cancer. Results Endoscopic biopsy failed to reveal malignancy in 15.9% of the 126 cases. Microlymphovascular invasion was present in 17 cases (56.7%) of the 30 T1 cancers but was absent in all cases of the 6 Tis cancers ( P = .02). Neither the gross appearance ( P = .51) nor the pathologic subtype ( P = .28) could predict the microinvasion rate. Limitations Single-center, retrospective study with small number of patients. Conclusions Although endoscopic resection improves the low predictability of endoscopic biopsy, surgical resection should be performed for the T1 stage Ampulla of Vater cancer because of the high lymphovascular invasion rate. On the other hand, the safety of endoscopic resection should be evaluated by a large-scale study on Tis cancers to consider the absence of microinvasion.

  • Expression of cyclooxygenase-2 and its correlation with clinicopathologic factors of Ampulla of Vater cancer.
    Journal of Korean medical science, 2003
    Co-Authors: Hong Joo Kim, Tae Sung Sohn, Kyu Taek Lee, Jong Kyun Lee, Seung Woon Paik, Jong Chul Rhee
    Abstract:

    There has been no report for the expression of cyclooxygenase-2 (COX-2) and its clinicopathologic and biologic significance in Ampulla of Vater cancer. This study was aimed for the clarification of COX-2 expression and its biologic roles in Ampulla of Vater cancer. Fourty-six patients with Ampulla of Vater cancer were enrolled and their COX-2 expression and clinicopathologic features were analyzed. The median age of patients was 60 yr and the mean duration of follow-up was 35 months (range: 14-82 months). Immunohistochemical stainings for COX-2, Ki-67, CD34 and TUNEL staining were performed. The immunoreactive COX-2 expression was present in 24 (52.2%) patients of Ampulla of Vater cancer and mainly localized in cytosolic and perinuclear region. There was no significant difference in the length of survival between COX-2 postive and negative group (p=0.9420 by Log Rank test). Also, there were no significant differences of proliferation index (p=0.326), apoptotic index (p=0.764) and microvessel density (p=0.135) between COX-2 positive and negative group. Initial pTNM stage (p=0.0028 by Log Rank test) and blood transfusion over 4 pints during operation (p=0.0254 by Log Rank test) were independent prognostic factor in patients with Ampulla of Vater cancer. It is suggested that immunoreactivity of COX-2 is not correlated with clinicopathologic and biologic features of Ampulla of Vater cancer.

Muhammad Shaalan Beg - One of the best experts on this subject based on the ideXlab platform.

Taira Kinoshita - One of the best experts on this subject based on the ideXlab platform.

  • Therapeutic approach to tumors of the Ampulla of Vater.
    American journal of surgery, 2006
    Co-Authors: Akihiko Kobayashi, Masaru Konishi, Toshio Nakagohri, Shinichiro Takahashi, Taira Kinoshita
    Abstract:

    Abstract Background/Aim Indications for local resection for tumors of the Ampulla of Vater have not been established. The present study evaluated suitable treatments for tumors of the papilla of Vater. Patients and Methods Clinicopathological factors were reviewed for 53 patients with tumors of the Ampulla of Vater treated between February 1993 and August 2003. Results of 53 patients, 41 were treated surgically. Local resection was performed in 7 of these 41 patients, with a histologically involved margin evident in 4 patients. Lymph node metastasis was identified in 20 patients who received radical resection, including 1 patient with pT1 cancer. Conclusion Given the presence of some positive surgical margins, local resection is indicated as a therapeutic approach to tumors of the papilla of Vater only for benign tumors or some malignant tumors that cannot undergo pancreaticoduodenectomy (PD).

Gc Ooi - One of the best experts on this subject based on the ideXlab platform.