Ampullary Adenocarcinoma—Advancing Prognostication and Personalized Treatment
Menée auprès de 192 patients atteints d'un adénocarcinome de l'ampoule de Vater traité par résection (âge médian : 69 ans ; 64 % d'hommes) et à partir de données portant sur 3 411 patients, cette étude internationale met en évidence l'intérêt d'un système de classification génomique pour prédire la survie
Ampullary adenocarcinoma (AA) is a rare cancer characterized by significant variability in its clinical behavior, which presents major challenges for prognostication and treatment. The malignancy originates at the ampulla of Vater, the junction where the biliary, pancreatic, and digestive systems converge. The region’s anatomical complexity and heterogeneous landscape are defined by multiple epithelial types. Traditional immunohistologic classification into intestinal, pancreaticobiliary, or mixed subtypes has proven prognostically inconsistent, limiting its clinical utility. To address this unmet need, Ecker et al in their study use molecular testing to better delineate the divergent clinical outcomes of AA. This approach outperforms traditional immunohistologic classification and may establish a new standard.
JAMA Surgery , éditorial, 2023