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dc.contributor.authorAcharya, A
dc.contributor.authorMarkar, SR
dc.contributor.authorSodergren, MH
dc.contributor.authorMalietzis, G
dc.contributor.authorDarzi, A
dc.contributor.authorAthanasiou, T
dc.contributor.authorKhan, AZ
dc.date.accessioned2018-02-14T10:49:42Z
dc.date.issued2017-06
dc.identifier.citationThe British journal of surgery, 2017, 104 (7), pp. 814 - 822
dc.identifier.issn0007-1323
dc.identifier.urihttps://repository.icr.ac.uk/handle/internal/1067
dc.identifier.eissn1365-2168
dc.identifier.doi10.1002/bjs.10563
dc.description.abstractBACKGROUND:Periampullary cancers are uncommon malignancies, often amenable to surgery. Several studies have suggested a role for adjuvant chemotherapy and chemoradiotherapy in improving survival of patients with periampullary cancers, with variable results. The aim of this meta-analysis was to determine the survival benefit of adjuvant therapy for periampullary cancers. METHODS:A systematic review was undertaken of literature published between 1 January 2000 and 31 December 2015 to elicit and analyse the pooled overall survival associated with the use of either adjuvant chemotherapy or chemoradiotherapy versus observation in the treatment of surgically resected periampullary cancer. Included articles were also screened for information regarding stage, prognostic factors and toxicity-related events. RESULTS:A total of 704 titles were screened, of which 93 full-text articles were retrieved. Fourteen full-text articles were included in the study, six of which were RCTs. A total of 1671 patients (904 in the control group and 767 who received adjuvant therapy) were included. The median 5-year overall survival rate was 37·5 per cent in the control group, compared with 40·0 per cent in the adjuvant group (hazard ratio 1·08, 95 per cent c.i. 0·91 to 1·28; P = 0·067). In 32·2 per cent of patients who had adjuvant therapy, one or more WHO grade 3 or 4 toxicity-related events were noted. Advanced T category was associated worse survival (regression coefficient -0·14, P = 0·040), whereas nodal status and grade of differentiation were not. CONCLUSION:This systematic review found no associated survival benefit for adjuvant chemotherapy or chemoradiotherapy in the treatment of periampullary cancer.
dc.formatPrint
dc.format.extent814 - 822
dc.languageeng
dc.language.isoeng
dc.subjectAmpulla of Vater
dc.subjectHumans
dc.subjectAdenocarcinoma
dc.subjectCommon Bile Duct Neoplasms
dc.subjectDuodenal Neoplasms
dc.subjectChemotherapy, Adjuvant
dc.subjectSurvival Rate
dc.subjectChemoradiotherapy, Adjuvant
dc.titleMeta-analysis of adjuvant therapy following curative surgery for periampullary adenocarcinoma.
dc.typeJournal Article
dcterms.dateAccepted2017-03-16
rioxxterms.versionofrecord10.1002/bjs.10563
rioxxterms.licenseref.startdate2017-06
rioxxterms.typeJournal Article/Review
dc.relation.isPartOfThe British journal of surgery
pubs.issue7
pubs.notesNot known
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/Royal Marsden Clinical Units
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/Royal Marsden Clinical Units
pubs.publication-statusPublished
pubs.volume104en_US
pubs.embargo.termsNot known
dc.contributor.icrauthorDarzi, Araen
dc.contributor.icrauthorMarsden,en


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