Clinical Outcomes Of Early-Stage Ampullary Carcinoma: Ku Cancer Center Experience.

e16192 Background: Ampullary cancer (AC) is a rare GI malignancy. The management of the locoregional disease iscurative surgery.The role of adjuvant chemotherapy[CT] or combination chemoradiation[CRT] is not well established. We analyzed our institution’s experience in AC.Methods: From June 2006 to July 2016,54 patients with early stage AC were reviewed. Clinicopathological characteristics, PFS and OS were compared between the group who underwent surgery Vs. those who received adjuvant therapy after the surgery Results: The median age of the 54 patients [38(72%) males,15(27%)females] was 67(37-90). Most of patients were white 40(75%) with 5(3%) African American. 52%(28) have smoking history, alcohol abuse 20%(11) and history of pancreatitis 13%(7).In those with localized cancers9(16%)were not surgical candidates. Adjuvant treatment was administered in18(39%)[CT13(28%) CRT 5(11%)]The remaining28(61%) patients underwent surgery alone. A recurrence was noted in 40% of study group. Median OS of the cohort is 30ms with 5yr OS at 30%.Median PFS and OSfor surgery only group was50ms and 61 ms and for surgery + adjuvant therapy group was14ms and 32 months respectively. Compared to surgery alone, adjuvant CT or CRT had no statistically significant difference in terms of PFS(P = 0.56)or OS(P = 0.80). High risk features like peripancreatic extension(16%),perineural invasion(26%)Lymph node positivitivity(29%),Lymphovascular invasion (29% )showed a trend towards poor OS with HR of 1.8,1.6,1.4 and1.2 respectively but were not statistically significant. Conclusions: Despite potentially curative surgery for AC, the recurrence rate is high. In our study, adding adjuvant therapy was not associated with statistically improvement in the OS compared to surgery alone. The limitations of our study include single institution, retrospective study with small sample size. However, the Subgroups with high risk phenotypes such as histological subtypes, peripancreatic extension and Lymphovascular invasion are associated with benefit from adjuvant therapy. A trend in the statistical significance is observed and needs further validation in larger cohort.