This prospective, controlled, single-arm study represents a valuable effort in justifying the need of adjuvant treatment in patients with ampullary carcinoma. Since the studies of the Gastrointestinal Study Group (GITSG), we have seen a significant increase in the use of adjuvant treatment for periampullary carcinomas, albeit with conflicting results. Although the 89% actuarial overall survival reported by Mehta et al is one of the highest reported, these data should be considered with caution, because of the small number of patients with limited follow-up. It should be noted that the median survival has not been reached in this group of patients due to limited follow-up and 3 deaths, although the authors reported the median survival to be 34 months. In addition, the authors compared these results with those of patients diagnosed as having pancreatic cancer; thus, one would expect to see differences in survival due to the inherently poor prognosis of patients with this disease.
Alvarado CAR, Vickers SM. Adjuvant Chemoradiotherapy for "Unfavorable" Carcinoma of the Ampulla of Vater—Invited Critique. Arch Surg. 2001;136(1):69. doi:10.1001/archsurg.136.1.69