When a patient has pancreatic cancer most will do what it take to extend their life. There is a rare pancreatic cancer called periampullary adenocarcinoma in which chemotherapy will increase the patient's life span.
Ampullary cancer is a malignant tumor that arises from the Ampulla of Vater, the last centimeter of the common bile duct as it passes through the duodenum, the first section of the intestine. All pancreatic and biliary secretions enter the duodenum through the Ampulla of Vater.
A tumor blocking the Ampulla of Vater will interfere with drainage of the pancreatic and biliary secretions into the intestine. Jaundice results when the drainage of bile into the duodenum is blocked causing it to accumulate in in the bloodstream. Jaundice, the yellowing of the skin, is typically one of the first symptoms present with Ampullary cancer.
The diagnostic tests used to for ampullary cancer are similar to those for pancreatic cancer; endoscopy or endoscopic retrograde cholangiopancreatography (ERCP) are frequently used to make the diagnosis.
Histology of Periampullay adenocarcinoma
Patients with periampullary cancer who received chemotherapy and surgery lived longer than patients who did not receive the chemotherapy.
This is the finding of a large multi-center research effort that was published in the July 11 issue ofJAMA (Journal of the American Medical Association).
This an important large international multi-center study showing the benefit of chemotherapy after surgical resection of a specific type ofperiampullary cancer," James Farrell, MD, director of the University of California Los Angeles Medical Center Endoscopic Ultrasound Division of Digestive Diseases, told dailyRx in an email,
"It supports the use of adjuvant treatmentwithgemcitabinefor this group of patients," Dr. Farrell said.
Additional study is needed to learn more about this treatment option. "There were different survival outcomes by tumor type, although age, poorly differentiated tumor grade, and lymph node involvement were also independent survival factors,” the authors write.