Periampullary adenocarcinoma

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Ivy Abraham, MD
University of Illinois at Chicago
Chicago, IL
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Neeta K. Venepalli, MD, MBA
University of Illinois at Chicago
Chicago, IL
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Note: there is some overlap, especially in the earlier literature, between treatment regimens for periampullary adenocarcinoma and those for pancreatic adenocarcinoma, cholangiocarcinoma, and gallbladder cancer; please see those pages for additional regimens.


Guidelines

ESMO

NCCN

Adjuvant therapy

Observation

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Regimen

Study Evidence Comparator Comparative Efficacy
Takada et al. 2002 Phase III (C) 5-FU & Mitomycin Seems not superior
Neoptolemos et al. 2012 (ESPAC-3) Phase III (C) 1. 5-FU & Leucovorin
2. Gemcitabine
Seems not superior

No adjuvant therapy.

Preceding treatment

References

  1. Takada T, Amano H, Yasuda H, Nimura Y, Matsushiro T, Kato H, Nagakawa T, Nakayama T; Study Group of Surgical Adjuvant Therapy for Carcinomas of the Pancreas and Biliary Tract. Is postoperative adjuvant chemotherapy useful for gallbladder carcinoma? A phase III multicenter prospective randomized controlled trial in patients with resected pancreaticobiliary carcinoma. Cancer. 2002 Oct 15;95(8):1685-95. link to original article PubMed
  2. ESPAC-3: Neoptolemos JP, Moore MJ, Cox TF, Valle JW, Palmer DH, McDonald AC, Carter R, Tebbutt NC, Dervenis C, Smith D, Glimelius B, Charnley RM, Lacaine F, Scarfe AG, Middleton MR, Anthoney A, Ghaneh P, Halloran CM, Lerch MM, Oláh A, Rawcliffe CL, Verbeke CS, Campbell F, Büchler MW; European Study Group for Pancreatic Cancer. Effect of adjuvant chemotherapy with fluorouracil plus folinic acid or gemcitabine vs observation on survival in patients with resected periampullary adenocarcinoma: the ESPAC-3 periampullary cancer randomized trial. JAMA. 2012 Jul 11;308(2):147-56. Erratum in: JAMA. 2012 Nov 14;308(18):1861. link to original article PubMed