論文種別	原著(症例報告除く)
言語種別	英語
査読の有無	その他(不明)
表題	Histopathologic Subtype as a Determinant of Prognosis and Chemotherapy Benefit in Resected Ampullary Adenocarcinoma.
掲載誌名	正式名：Journal of hepato-biliary-pancreatic sciences 略　 称：J Hepatobiliary Pancreat Sci ISSNコード：18686982/18686974
掲載区分	国外
巻・号・頁	pp.Online ahead of print
著者・共著者	Riccardo Pellegrini, Valentina Del Chiaro, Salvador Rodriguez Franco, Hiroyuki Ishida, Atsushi Nara, Karla Navarrete Galvez, Benedetto Mungo, Marco Del Chiaro, Richard D Schulick
発行年月	2026/03
概要	BACKGROUND:Ampullary adenocarcinoma (AAC) is a rare malignancy with heterogeneous biological behavior. Although surgical resection is the only potentially curative option, the prognostic role of histopathologic features and adjuvant chemotherapy (AC) remains unclear.METHODS:Consecutive patients undergoing curative-intent pancreatoduodenectomy for AAC at the University of Colorado Hospital between January 2013 and May 2025 were retrospectively reviewed. Clinicopathologic variables associated with overall (OS) and recurrence-free survival (RFS) were analyzed using multivariable Cox regression.RESULTS:Ninety-seven patients were included. Median OS was 93.9 months with 1-, 3-, 5-, and 10-year OS rates of 89%, 67%, 59%, and 46%. Older age (HR, 3.79; 95% CI, 1.71-8.41), lymph node (LN) involvement (HR, 4.92; 95% CI, 1.87-12.93), and R1 margin (HR, 4.33; 95% CI, 1.09-17.25) independently predicted poorer OS. The pancreatobiliary subtype (pbAAC) showed worse OS than the intestinal subtype (iAAC) (5-year OS, 48% vs. 75%; p = 0.012). In pbAAC, LN metastasis (HR, 4.16; 95% CI, 1.31-13.18) and R1 margin (HR, 5.47; 95% CI, 1.10-27.20) predicted worse OS, whereas AC was associated with improved survival (HR, 0.404; 95% CI, 0.18-0.91). No AC benefit was observed in iAAC (p = 0.323).CONCLUSIONS:Histopathologic subtype is a key prognostic factor in AAC, with AC associated with better survival in pbAAC.
DOI	10.1002/jhbp.70100
PMID	41821156