Imperial College London
Alternate

Professor the Lord Darzi of Denham PC KBE FRS FMedSci HonFREng

Faculty of Medicine, Department of Surgery & Cancer

Co-Director of the IGHI, Professor of Surgery
 
 
 
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Contact

 

+44 (0)20 3312 1310a.darzi

 
 
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Location

 

Queen Elizabeth the Queen Mother Wing (QEQM)St Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Acharya:2017:10.1002/bjs.10563,
author = {Acharya, A and Markar, SR and Sodergren, MH and Malietzis, G and Darzi, A and Athanasiou, T and Khan, AZ},
doi = {10.1002/bjs.10563},
journal = {British Journal of Surgery},
pages = {814--822},
title = {Meta-analysis of adjuvant therapy following curative surgery for periampullary adenocarcinoma},
url = {http://dx.doi.org/10.1002/bjs.10563},
volume = {104},
year = {2017}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BackgroundPeriampullary 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.MethodsA 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.ResultsA 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.ConclusionThis systematic review found no associated survival benefit for adjuvant chemotherapy or chemoradiotherapy in the treatment of periampullary cancer.
AU  - Acharya,A
AU  - Markar,SR
AU  - Sodergren,MH
AU  - Malietzis,G
AU  - Darzi,A
AU  - Athanasiou,T
AU  - Khan,AZ
DO  - 10.1002/bjs.10563
EP  - 822
PY  - 2017///
SN  - 1365-2168
SP  - 814
TI  - Meta-analysis of adjuvant therapy following curative surgery for periampullary adenocarcinoma
T2  - British Journal of Surgery
UR  - http://dx.doi.org/10.1002/bjs.10563
UR  - http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000402756600004&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
UR  - http://hdl.handle.net/10044/1/49294
VL  - 104
ER  -
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