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AIM:To provide trends in incidence,management and survival of cancer of the ampulla of Vater in a welldefined French population.METHODS:Data were obtained from the populationbased digestive cancer registry of Burgundy over a34-year period.Age-standardized incidence rates were computed using the world standard population.Average annual variations in incidence rates were estimated using a poisson regression.A univariate and multivariate relative survival analysis was performed.RESULTS:Age-standardized incidence rates were0.46 and 0.30 per 100000 inhabitants for men and women,respectively.Incidence rate increased from0.26(1976-1984)to 0.58(2003-2009)for men and remained stable for women.Resection for cure was performed in 48.3%of cases.This proportion was stable over the study period.Among cases with curative resection,pancreatico-duodenectomy was performed in94.0%of cases and ampullectomy in 6.0%of cases.A total of 50.8%of cancers of the ampulla of Vater were diagnosed at an advanced stage.Their proportion remained stable throughout the study period.The overall1-and 5-year relative survival rates were 60.2%and27.7%,respectively.Relative survival did not vary over time.Treatment and stage at diagnosis were the most important determinants of survival.The 5-year relative survival rate was 41.5%after resection for cure,9.5%after palliative surgery and 6.7%after symptomatic treatment.In multivariate analysis,only stage at diagnosis significantly influenced the risk of death.CONCLUSION:Cancer of the ampulla of Vater is still uncommon,but its incidence increased for men in Burgundy.Diagnosis is often made at an advanced stage,dramatically worsening the prognosis.
AIM: To provide trends in incidence, management and survival of cancer of the ampulla of Vater in a welldefined French population. METHODS: Data were obtained from the population based digestive cancer registry of Burgundy over a 34-year period. Age-standardized incidence rates were computed using the world standard population. Average annual variations in incidence rates were estimated using a poisson regression. A univariate and multivariate relative survival analysis was performed .RESULTS: Age-normal incidence rates were 0.46 and 0.30 per 100000 inhabitants for men and women, respectively .Incidence rate increased from 0.26 (1976-1984) to 0.58 (2003-2009) for men and remained stable for women. Review for cure was performed in 48.3% of cases. This proportion was stable over the study period. Among cases with curative resection, pancreatico-duodenectomy was performed in 94.0% of cases and ampullectomy in 6.0% of cases. A total of 50.8% of cancers of the ampulla of Vater were diagnosed at an advanced sta ge.Their proportion was stable throughout the study period. The overall 1- and 5-year relative survival rates were 60.2% and27.7%, respectively. Relative survival did not vary over time. Treatment and stage at diagnosis were the most important determinants of survival. The 5-year relative survival rate was 41.5% after resection for cure, 9.5% after palliative surgery and 6.7% after symptomatic treatment. Multivariate analysis, only stage at diagnosis significantly influenced the risk of death. CONCLUSION: Cancer of the ampulla of Vater is still uncommon, but its incidence increased for men in Burgundy. Diagnosis is often made at an advanced stage, dramatically worsening the prognosis.