Periampullary adenocarcinoma

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Eric Marks Headshot.jpg
Eric I. Marks, MD
Boston University
Boston, MA, USA
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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.


Given the rapid change in evidence in many areas of hematology/oncology, readers are encouraged to consider any guideline published 5+ years ago to be for historical purposes, only.



Adjuvant therapy



Study Dates of enrollment Evidence Comparator Comparative Efficacy
Takada et al. 2002 1986-1992 Phase 3 (C) 5-FU & Mitomycin Did not meet primary endpoint of OS
Neoptolemos et al. 2012 (ESPAC-3) 2000-2008 Phase 3 (C) 1. FULV
2. Gemcitabine
Did not meet primary endpoint of OS

No adjuvant therapy.

Preceding treatment


  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 NCT00058201