{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T23:03:03Z","timestamp":1785366183094,"version":"3.55.0"},"reference-count":31,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,12,26]],"date-time":"2023-12-26T00:00:00Z","timestamp":1703548800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Annals of Gastroent Surgery"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Carcinoma of the ampulla of Vater (CAV) shows a favorable prognosis compared to that with the other periampullary tumors, while some cases have a poor prognosis. The aims of the present study are to clarify the clinicopathological factors associated with poor recurrence\u2010free survival (RFS) in patients with CAV after curative resection and to validate the usefulness of adjuvant chemotherapy (AC).<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients<\/jats:title><jats:p>The study design is a multicenter retrospective cohort study. Patients with CAV who underwent pancreaticoduodenectomy between January 2008 and December 2020 at 26 hospitals were analyzed. The 30 clinicopathological factors were evaluated. A propensity score matching (PSM) was used to compare between patients with and without AC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Finally, 460 patients were analyzed. Median duration of follow\u2010up was 47.2\u2009months. Twenty\u2010one prognostic factors associated with poor RFS were identified by univariate analysis. In multivariate analysis, aged \u226571, tumor diameter \u226512\u2009mm, pT2 or higher stage (pT\u22652), portal vein invasion (PV+), venous invasion(V+), and node positive disease (pN+) were independent prognostic factors for poor RFS. Out of 80 patients who received AC, 63 patients were assigned to analysis for PSM. The results showed no beneficial effect of AC on RFS. The preoperative factors potentially predicting pT\u22652, V+, and\/or N+ were at least one of following; (1) CA19\u20109\u2009&gt;\u200937\u2009IU\/mL, (2) ulcerative or mixed type appearance, (3) except for well\u2010differentiated tumor, or (4) except for intestinal subtype of histology.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Aged \u226571, tumor diameter\u2009\u226512\u2009mm, pT\u22652, PV+, V+, and pN+ were independent prognostic factors for poor RFS in patients with CAV. An additional therapeutic strategy may be desirable in CAV patients at high risk for recurrence.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ags3.12764","type":"journal-article","created":{"date-parts":[[2023,12,27]],"date-time":"2023-12-27T06:30:17Z","timestamp":1703658617000},"page":"190-201","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Identification of patients at high risk for recurrence in carcinoma of the ampulla of Vater: Analysis in 460 patients"],"prefix":"10.1002","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7872-0724","authenticated-orcid":false,"given":"Masato","family":"Narita","sequence":"first","affiliation":[{"name":"Department of Surgery National Hospital Organization Kyoto Medical Center  Kyoto Japan"},{"name":"Department of Surgery Kobe City Medical Center General Hospital  Kobe Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Etsuro","family":"Hatano","sequence":"additional","affiliation":[{"name":"Department of Surgery, Graduate School of Medicine Kyoto University  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koji","family":"Kitamura","sequence":"additional","affiliation":[{"name":"Department of Surgery Hyogo Prefectural Amagasaki General Medical Center  Amagasaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ken","family":"Fukumitsu","sequence":"additional","affiliation":[{"name":"Department of Surgery Kyoto Katsura Hospital  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hirohisa","family":"Kitagawa","sequence":"additional","affiliation":[{"name":"Department of Surgery Kurashiki Central Hospital  Kurashiki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuhei","family":"Hamaguchi","sequence":"additional","affiliation":[{"name":"Department of Surgery Japanese Red Cross Osaka Hospital  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takefumi","family":"Yazawa","sequence":"additional","affiliation":[{"name":"Department of Surgery Shiga General Hospital  Shiga Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroaki","family":"Terajima","sequence":"additional","affiliation":[{"name":"Department of Surgery Kitano Hospital  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuhiko","family":"Kitaguchi","sequence":"additional","affiliation":[{"name":"Department of Surgery Japanese Red Cross Otsu Hospital  Otsu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshihiko","family":"Hata","sequence":"additional","affiliation":[{"name":"Department of Surgery Kobe City Medical Center West Hospital  Kobe Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the Kyoto University Hepato\u2010Biliary Pancreatic surgery Study Group (KUHBPS)","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,12,26]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13277-013-1153-9"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.21873\/anticanres.15806"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.14701\/kjhbps.2011.15.3.171"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejso.2022.10.001"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00595-021-02270-0"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000003177"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPA.0000000000000112"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/jhbp.1229"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2019.1170"},{"issue":"9","key":"e_1_2_11_11_1","first-page":"1001","article-title":"Prognostic nutritional index in gastrointestinal surgery of malnourished cancer patients","volume":"85","author":"Onodera T","year":"1984","journal-title":"Nihon Geka Gakkai Zasshi"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2016.11.014"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.sla.0000133083.54934.ae"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-014-2916-1"},{"key":"e_1_2_11_15_1","volume-title":"General rules for clinical and pathological studies on cancer of the biliary tract","author":"Surgery. JSoH\u2010B\u2010P","year":"2021"},{"key":"e_1_2_11_16_1","volume-title":"WHO classification of tumours of the digestive system","author":"Bosman FTWHO","year":"2010"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1349-7006.1994.tb02077.x"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pan.2020.01.009"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(22)02038-4"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(18)30915-X"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.18.00050"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.10776"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.10870"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1093\/jjco\/hyaa018"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2020.7328"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.19.02274"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2019.37.4_suppl.189"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1186\/1746-1596-5-75"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ccell.2015.12.012"},{"key":"e_1_2_11_30_1","unstructured":"U.S. Department of Health and Human Services Food and Drug Administration Oncology Center of Excellence.Clinical Trial Endpoints for the Approval of Cancer Drugs and Biologics.2018Available from:https:\/\/www.fda.gov\/media\/71195\/download"},{"key":"e_1_2_11_31_1","unstructured":"EM. A.Guideline on the Evaluation of Anticancer Medicinal Products.2017Available from:https:\/\/www.ema.europa.eu\/en\/documents\/scientific\u2010guideline\/guideline\u2010evaluation\u2010anticancer\u2010medicinal\u2010products\u2010man\u2010revision\u20105_en.pdf"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2014.05.016"}],"container-title":["Annals of Gastroenterological Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ags3.12764","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,3,6]],"date-time":"2024-03-06T03:47:08Z","timestamp":1709696828000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ags3.12764"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12,26]]},"references-count":31,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2024,3]]}},"alternative-id":["10.1002\/ags3.12764"],"URL":"https:\/\/doi.org\/10.1002\/ags3.12764","archive":["Portico"],"relation":{},"ISSN":["2475-0328","2475-0328"],"issn-type":[{"value":"2475-0328","type":"print"},{"value":"2475-0328","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,12,26]]},"assertion":[{"value":"2023-09-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-11-21","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-12-26","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}