{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T13:30:18Z","timestamp":1787319018297,"version":"build-2736575974"},"reference-count":30,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T00:00:00Z","timestamp":1773273600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T00:00:00Z","timestamp":1773273600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Hepato Biliary Pancreat"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Consecutive patients undergoing curative\u2010intent 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\u2010free survival (RFS) were analyzed using multivariable Cox regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Ninety\u2010seven patients were included. Median OS was 93.9\u2009months with 1\u2010, 3\u2010, 5\u2010, and 10\u2010year OS rates of 89%, 67%, 59%, and 46%. Older age (HR, 3.79; 95% CI, 1.71\u20138.41), lymph node (LN) involvement (HR, 4.92; 95% CI, 1.87\u201312.93), and R1 margin (HR, 4.33; 95% CI, 1.09\u201317.25) independently predicted poorer OS. The pancreatobiliary subtype (pbAAC) showed worse OS than the intestinal subtype (iAAC) (5\u2010year OS, 48% vs. 75%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.012). In pbAAC, LN metastasis (HR, 4.16; 95% CI, 1.31\u201313.18) and R1 margin (HR, 5.47; 95% CI, 1.10\u201327.20) predicted worse OS, whereas AC was associated with improved survival (HR, 0.404; 95% CI, 0.18\u20130.91). No AC benefit was observed in iAAC (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.323).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Histopathologic subtype is a key prognostic factor in AAC, with AC associated with better survival in pbAAC.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jhbp.70100","type":"journal-article","created":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T04:51:04Z","timestamp":1773377464000},"page":"537-547","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Histopathologic Subtype as a Determinant of Prognosis and Chemotherapy Benefit in Resected Ampullary Adenocarcinoma"],"prefix":"10.1002","volume":"33","author":[{"given":"Riccardo","family":"Pellegrini","sequence":"first","affiliation":[{"name":"Division of Surgical Oncology, Department of Surgery University of Colorado School of Medicine  Aurora Colorado USA"},{"name":"Hepato\u2010Pancreato\u2010Biliary and Liver Transplant Surgery Unit, Department of Surgical, Oncological and Gastroenterological Sciences (DISCOG), university of Padua  Padua Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Del Chiaro","sequence":"additional","affiliation":[{"name":"Division of Surgical Oncology, Department of Surgery University of Colorado School of Medicine  Aurora Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salvador Rodriguez","family":"Franco","sequence":"additional","affiliation":[{"name":"Division of Surgical Oncology, Department of Surgery University of Colorado School of Medicine  Aurora Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyuki","family":"Ishida","sequence":"additional","affiliation":[{"name":"Division of Surgical Oncology, Department of Surgery University of Colorado School of Medicine  Aurora Colorado USA"},{"name":"Department of Hepatobiliary and Pancreatic Surgery Institute of Science Tokyo  Tokyo Japan"},{"name":"Department of Pancreatobiliary Surgery Kansai Medical University  Hirakata Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsushi","family":"Nara","sequence":"additional","affiliation":[{"name":"Division of Surgical Oncology, Department of Surgery University of Colorado School of Medicine  Aurora Colorado USA"},{"name":"Department of Pancreatobiliary Surgery Kansai Medical University  Hirakata Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karla Navarrete","family":"Galvez","sequence":"additional","affiliation":[{"name":"Division of Surgical Oncology, Department of Surgery University of Colorado School of Medicine  Aurora Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benedetto","family":"Mungo","sequence":"additional","affiliation":[{"name":"Division of Surgical Oncology, Department of Surgery University of Colorado School of Medicine  Aurora Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Del Chiaro","sequence":"additional","affiliation":[{"name":"Division of Surgical Oncology, Department of Surgery University of Colorado School of Medicine  Aurora Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard D.","family":"Schulick","sequence":"additional","affiliation":[{"name":"Division of Surgical Oncology, Department of Surgery University of Colorado School of Medicine  Aurora Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,12]]},"reference":[{"key":"e_1_2_15_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejso.2021.02.028"},{"key":"e_1_2_15_3_1","unstructured":"M.Del Chiaro D. 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