a_ampulla

最後更新於 Mar 1, 2024 🪚 編輯原始文件

🌱 來自：snippets from oncologists

# Ampulla of Vater adenocarcinoma,(W/D), pT3N1(3/15)M0, stage IIB (AJCC 7th), invade duodenal wall and pancreas, negative washing cytology s/p Whipple and feeding jejunostomy on `_`/`_`/`___`, LVI+, perineural invasion -, post op complicated with gastroparesis, UGIB

LNs (3/15 totally): positive for metastasis [3/15 (peri-tumoral LN: 2/5, peripancreatic LN: 1/3, perigastric LN: 0/3, CBD LN: 0/1, SMA LN: 0/1, LN8+9: 0/1, LN12P: 0/1, LN12A: 0/0)] with extracapsular spread.
Initial presentation: ___
Treatment plan: adjuvant chemotherapy will be started post op 4~6 weeks
Feeding: jejunostomy tube ___/___/___
Follow up parameter:
- abdominal CT scan ( ___/___/___
- and tumor marker

adjuvant_chemotherapy_purpose: to prolong disease-free survival and overall survival, and decrease the risk of recurrence and distant metastases, but not 100%.
adjuvant_chemotherapy_regimen options:
- 5FU_LV:
  - regimen: “5FU D1-D5 (425mg/m2) IV, LV (20mg/m2) Q4W for 6 cycles”
- gemcitabine: (out-of-pocket)
  - regimen: “Self-paid gemcitabine 1000mg/m2 IVF 30 min QW for 3 weeks on, 1 week off for 6 cycles”
  - mortality_reduction: “Reduce risk of mortality by 30%”

admission_arrangement: “Consider start treatment, arrange admission for 5FU D1-D5 (425mg/m2) IV, LV (20mg/m2), check lab and tumor marker.”
- assessments before chemotherapy:
  - Vascular
  - Nutritional