{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T15:42:46Z","timestamp":1759160566931},"reference-count":19,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2016,8]]},"abstract":"<jats:sec>\n            <jats:title>Objectives:<\/jats:title>\n            <jats:p>To analyze the outcome of patients with ampullary cancer who had undergone curative surgery followed by adjuvant chemoradiotherapy and to identify the prognostic factors for these patients<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>Between January 1991 and August 2006, 71 patients with ampullary cancer underwent curative resection followed by adjuvant radiotherapy. There were 38 males and 33 females, and median age was 56 years (range, 28 to 77 y). Postoperative radiotherapy was delivered to tumor bed and regional lymph nodes up to 40 to 50 Gy at 2 Gy\/fraction; 67 patients also received intravenous 5-fluorouracil as a radiosensitizer. Median follow-up duration was 72 months for survivors.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>There were 5 isolated locoregional recurrences, 20 isolated distant metastases, and 11 combined locoregional and distant relapses. The 5-year locoregional relapse-free and overall survival rates were 76.2% and 64.5%, respectively. On multivariate analysis, nodal ratio and histologic differentiation were significant prognostic factors for overall survival (<jats:italic toggle=\"yes\">P<\/jats:italic>=0.0382 and 0.0331, respectively).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>Adjuvant chemoradiotherapy after curative resection can achieve a long-term survival rate in patients with ampullary cancer. Nodal ratio and histologic differentiation are independent prognostic factors for these patients.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/coc.0000000000000075","type":"journal-article","created":{"date-parts":[[2014,4,22]],"date-time":"2014-04-22T15:32:22Z","timestamp":1398180742000},"page":"346-349","source":"Crossref","is-referenced-by-count":6,"title":["Prognostic Significance of Nodal Ratio in Patients Undergoing Adjuvant Chemoradiotherapy After Curative Resection for Ampullary Cancer"],"prefix":"10.1097","volume":"39","author":[{"given":"Kyubo","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, Ewha Womans University School of Medicine, Yangcheon-gu"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eui Kyu","family":"Chie","sequence":"additional","affiliation":[{"name":"Radiation Oncology"},{"name":"Institute of Radiation Medicine, Medical Research Center, Seoul National University, Jongno-gu, Seoul, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jin-Young","family":"Jang","sequence":"additional","affiliation":[{"name":"Surgery"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sun Whe","family":"Kim","sequence":"additional","affiliation":[{"name":"Surgery"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sae-Won","family":"Han","sequence":"additional","affiliation":[{"name":"Internal Medicine, Seoul National University College of Medicine, Jongno-gu"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Do-Youn","family":"Oh","sequence":"additional","affiliation":[{"name":"Internal Medicine, Seoul National University College of Medicine, Jongno-gu"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seock-Ah","family":"Im","sequence":"additional","affiliation":[{"name":"Internal Medicine, Seoul National University College of Medicine, Jongno-gu"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tae-You","family":"Kim","sequence":"additional","affiliation":[{"name":"Internal Medicine, Seoul National University College of Medicine, Jongno-gu"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yung-Jue","family":"Bang","sequence":"additional","affiliation":[{"name":"Internal Medicine, Seoul National University College of Medicine, Jongno-gu"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sung W.","family":"Ha","sequence":"additional","affiliation":[{"name":"Radiation Oncology"},{"name":"Institute of Radiation Medicine, Medical Research Center, Seoul National University, Jongno-gu, Seoul, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"R1-20230905","doi-asserted-by":"crossref","first-page":"544","DOI":"10.1097\/00000658-198910000-00015","article-title":"Experience with 647 consecutive tumors of the duodenum, ampulla, head of the pancreas, and distal common bile duct","volume":"210","author":"Michelassi","year":"1989","journal-title":"Ann Surg"},{"key":"R2-20230905","doi-asserted-by":"crossref","first-page":"821","DOI":"10.1097\/00000658-199806000-00005","article-title":"Periampullary adenocarcinoma: analysis of 5-year survivors","volume":"227","author":"Yeo","year":"1998","journal-title":"Ann Surg"},{"key":"R3-20230905","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1001\/archsurg.1991.01410270099016","article-title":"Radical resection for carcinoma of the ampulla of Vater","volume":"126","author":"Monson","year":"1991","journal-title":"Arch Surg"},{"key":"R4-20230905","doi-asserted-by":"crossref","first-page":"1717","DOI":"10.1002\/1097-0142(19901015)66:8<1717::AID-CNCR2820660811>3.0.CO;2-4","article-title":"Long-term follow-up of 24 patients undergoing radical resection for ampullary carcinoma, 1953 to 1988","volume":"66","author":"Shutze","year":"1990","journal-title":"Cancer"},{"key":"R5-20230905","doi-asserted-by":"crossref","first-page":"899","DOI":"10.1001\/archsurg.1985.01390320023003","article-title":"Pancreatic cancer: adjuvant combined radiation and chemotherapy following curative resection","volume":"120","author":"Kalser","year":"1985","journal-title":"Arch Surg"},{"key":"R6-20230905","doi-asserted-by":"crossref","first-page":"776","DOI":"10.1097\/00000658-199912000-00006","article-title":"Adjuvant radiotherapy and 5-fluorouracil after curative resection of cancer of the pancreas and periampullary region: phase III trial of the EORTC Gastrointestinal Tract Cancer Cooperative Group","volume":"230","author":"Klinkenbijl","year":"1999","journal-title":"Ann Surg"},{"key":"R7-20230905","doi-asserted-by":"crossref","first-page":"436","DOI":"10.1016\/j.ijrobp.2008.11.067","article-title":"Role of adjuvant chemoradiotherapy for ampulla of Vater cancer","volume":"75","author":"Kim","year":"2009","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"R8-20230905","doi-asserted-by":"crossref","first-page":"735","DOI":"10.1016\/j.ijrobp.2007.07.2327","article-title":"Role of adjuvant chemoradiation therapy in adenocarcinomas of the ampulla of Vater","volume":"70","author":"Krishnan","year":"2008","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"R9-20230905","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1186\/1748-717X-6-126","article-title":"Evaluation of adjuvant chemoradiation therapy for ampullary adenocarcinoma: the Johns Hopkins Hospital\u2014Mayo Clinic collaborative study","volume":"6","author":"Narang","year":"2011","journal-title":"Radiat Oncol"},{"key":"R10-20230905","doi-asserted-by":"crossref","first-page":"1341","DOI":"10.1016\/0360-3016(95)00060-C","article-title":"Toxicity criteria of the Radiation Therapy Oncology Group (RTOG) and the European Organization for Research and Treatment of Cancer (EORTC)","volume":"31","author":"Cox","year":"1995","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"R11-20230905","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1002\/1097-0142(19810101)47:1<207::AID-CNCR2820470134>3.0.CO;2-6","article-title":"Reporting results of cancer treatment","volume":"47","author":"Miller","year":"1981","journal-title":"Cancer"},{"key":"R12-20230905","doi-asserted-by":"crossref","first-page":"8706","DOI":"10.1200\/JCO.2005.02.8852","article-title":"Colon cancer survival is associated with decreasing ratio of metastatic to examined lymph nodes","volume":"23","author":"Berger","year":"2005","journal-title":"J Clin Oncol"},{"key":"R13-20230905","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1097\/01.sla.0000250423.43436.e1","article-title":"The ratio between metastatic and examined lymph nodes (N ratio) is an independent prognostic factor in gastric cancer regardless of the type of lymphadenectomy: results from an Italian multicentric study in 1853 patients","volume":"245","author":"Marchet","year":"2007","journal-title":"Ann Surg"},{"key":"R14-20230905","doi-asserted-by":"crossref","first-page":"610","DOI":"10.1016\/j.surg.2006.12.013","article-title":"Prognostic relevance of lymph node ratio following pancreaticoduodenectomy for pancreatic cancer","volume":"141","author":"Pawlik","year":"2007","journal-title":"Surgery"},{"key":"R15-20230905","doi-asserted-by":"crossref","first-page":"2118","DOI":"10.1007\/s00268-011-1175-7","article-title":"Assessment of the nodal status in ampullary carcinoma: the number of positive lymph nodes versus the lymph node ratio","volume":"35","author":"Sakata","year":"2011","journal-title":"World J Surg"},{"key":"R16-20230905","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1002\/jso.21283","article-title":"Lymph node involvement in ampullary cancer: the importance of the number, ratio, and location of metastatic nodes","volume":"100","author":"Sierzega","year":"2009","journal-title":"J Surg Oncol"},{"key":"R17-20230905","doi-asserted-by":"crossref","first-page":"3178","DOI":"10.1245\/s10434-008-0099-4","article-title":"Prognostic relevance of lymph node ratio and number of resected nodes after curative resection of ampulla of Vater carcinoma","volume":"15","author":"Falconi","year":"2008","journal-title":"Ann Surg Oncol"},{"key":"R18-20230905","doi-asserted-by":"crossref","first-page":"1328","DOI":"10.1016\/j.ijrobp.2010.07.1993","article-title":"The influence of total nodes examined, number of positive nodes, and lymph node ratio on survival after surgical resection and adjuvant chemoradiation for pancreatic cancer: a secondary analysis of RTOG 9704","volume":"81","author":"Showalter","year":"2011","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"R19-20230905","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1007\/PL00002402","article-title":"Split-course radiotherapy: where do we stand","volume":"177","author":"Dubben","year":"2001","journal-title":"Strahlenther Onkol"}],"container-title":["American Journal of Clinical Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/00000421-201608000-00006","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,5]],"date-time":"2023-09-05T23:37:13Z","timestamp":1693957033000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/00000421-201608000-00006"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,8]]},"references-count":19,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2016]]}},"URL":"https:\/\/doi.org\/10.1097\/coc.0000000000000075","relation":{},"ISSN":["0277-3732"],"issn-type":[{"value":"0277-3732","type":"print"}],"subject":[],"published":{"date-parts":[[2016,8]]}}}