A population-based study on incidence, treatment, and survival in ampullary cancer in the Netherlands. Issue 7 (July 2021)

• Record Type: Journal Article
• Authors: de Jong, Evelien J.M.; Geurts, Sandra M.E.; van der Geest, Lydia G.; Besselink, Marc G.; Bouwense, Stefan A.W.; Buijsen, Jeroen; Dejong, Cornelis H.C.; Heij, Lara R.; Koerkamp, Bas Groot; de Hingh, Ignace H.J.T.; Hoge, Chantal; Kazemier, Geert; van Laarhoven, Hanneke W.M.; de Meijer, Vincent E.; Mohammad, Nadia Haj; Strijker, Marin; Timmermans, Karin C.A.A.; Valkenburg-van Iersel, Liselot B.J.; Wilmink, Johanna W.; Tjan-Heijnen, Vivianne C.G.; de Vos-Geelen, Judith
• Is Part Of: European journal of surgical oncology. Volume 47:Issue 7(2021)
• Page Start: 1742
• Page End: 1749
• Publication Date: 2021-07
• Subjects: Ampullary cancer -- Ampulla of vater -- Epidemiology -- Survival -- Treatment -- Trends; EAPC estimated annual percentage change -- ESP European standard population -- NCR Netherlands Cancer Registry -- NOS not otherwise specified -- RESP revised European standard population -- UICC Union for International Cancer Control; Oncology -- Periodicals; Cancer -- Surgery -- Periodicals; Medical Oncology -- Periodicals; Neoplasms -- surgery -- Periodicals; Cancer -- Chirurgie -- Périodiques; Cancérologie -- Périodiques; Oncologie; Chirurgie (geneeskunde); Electronic journals; Electronic journals -- Sciences; Electronic journals -- Medicine; Electronic journals; 616.994059005
• DOI: 10.1016/j.ejso.2021.02.028
• Languages: English
• ISSNs: 0748-7983

Abstract

Abstract: Introduction: Ampullary cancer is rare and as a result epidemiological data are scarce. The aim of this population-based study was to determine the trends in incidence, treatment and overall survival (OS) in patients with ampullary adenocarcinoma in the Netherlands between 1989 and 2016. Methods: Patients diagnosed with ampullary adenocarcinoma were identified from the Netherlands Cancer Registry. Incidence rates were age-adjusted to the European standard population. Trends in treatment and OS were studied over (7 years) period of diagnosis, using Kaplan-Meier and Cox regression analyses for OS and stratified by the presence of metastatic disease. Results: In total, 3840 patients with ampullary adenocarcinoma were diagnosed of whom, 55.0% were male and 87.1% had non-metastatic disease. The incidence increased from 0.59 per 100, 000 in 1989–1995 to 0.68 per 100, 000in 2010–2016. In non-metastatic disease, the resection rate increased from 49.5% in 1989–1995 to 63.9% in 2010–2016 (p < 0.001). The rate of adjuvant therapy increased from 3.1% to 7.9%. In non-metastatic disease, five-year OS (95% CI) increased from 19.8% (16.9–22.8) in 1989–1995 to 29.1% (26.0–31.2) in 2010–2016 (logrank p < 0.001). In patients with metastatic disease, median OS did not significantly improve (from 4.4 months (3.6–5.0) to 5.9 months (4.7–7.1); logrank p = 0.06). Cancer treatment was an independent prognostic factor for OS among all patients. Conclusion: Both incidence and OS of ampullary cancer increased from 1989 to 2016 which is most likely related to the observed increased resection rates and use of adjuvant therapy. Highlights: Over time, the incidence of ampullary cancer in the Netherlands increased. Resection was 50% of non-metastatic disease in 1989–1995 and 64% in 2010–2016. Five-year overall survival increased from 20% to 29% in non-metastatic disease. Treatment choices and overall survival in metastatic disease were similar over time.