Trends in incidence and management of cancer of the ampulla of Vater

Table 1 Trends in treatment and stage at diagnosis of cancer of the ampulla of Vater

	1976-1984(n = 25)	1985-1993(n = 67)	1994-2002(n = 82)	2003-2009(n = 81)
Treatment
Resection for cure	40.0%	51.5%	48.8%	49.4%
Palliative surgery	44.0%	27.9%	29.3%	35.8%
Symptomatic treatment	16.0%	20.6%	22.0%	14.8%
Stage at diagnosis1
Stage I	16.0%	23.5%	24.4%	25.9%
Stage II	16.0%	23.5%	24.4%	14.8%
Stage III	8.0%	3.0%	3.7%	7.4%
Stage IV	60.0%	48.5%	47.5%	51.9%

¹Stage unknown: 1 case in 1985-1993.

Table 2 Relative survival rate for cancer of ampulla of Vater by sex, age, period at diagnosis, stage at diagnosis and treatment in Burgundy (France) between 1976 and 2009

	n	Relative survival			P value
		1 yr	3 yr	5 yr
Sex					0.6356
Men	130	61.9%	35.0%	30.2%
Women	122	58.7%	33.5%	23.8%
Age at diagnosis					0.0012
< 60 yr	46	76.5%	50.2%	45.5%
60-74 yr	89	62.8%	33.9%	24.0%
> 74 yr	117	51.3%	26.7%	19.6%
Treatment					< 0.0001
Resection for cure	124	77.8%	48.6%	41.5%
Palliative surgery	81	55.2%	17.8%	9.5%
Symptomatic treatment	47	26.5%	17.1%	6.7%
Stage at diagnosis					< 0.0001
Stage I	60	80.1%	62.0%	60.3%
Stage II	52	72.3%	40.2%	29.4%
Stage III	13	Not calculated
Stage IV	126	44.1%	17.5%	8.0%
Period at diagnosis					0.4526
1976-1984	25	54.5%	22.4%	14.0%
1985-1993	65	56.4%	31.0%	21.6%
1994-2002	82	67.7%	38.1%	31.6%
2003-2009	80	59.0%	36.0%	30.3%

Table 3 Multivariate relative survival analysis for cancer of the ampulla of Vater

	HR	95%CI	P value
Sex
Men	1.0
Women	0.9	0.7-1.3	0.66
Age at diagnosis
< 60 yr	1.0
60-74 yr	1.3	0.8-2.1	0.54
> 74 yr	1.2	0.7-2.0	0.60
Period at diagnosis
1976-1984	1.0
1985-1993	1.0	0.6-1.7	0.98
1994-2002	0.8	0.5-1.5	0.54
2003-2009	0.8	0.5-1.4	0.48
Stage at diagnosis
Stage I	1.0
Stage II	2.1	1.2-3.7	0.012
Stage III	3.2	1.5-6.9	0.003
Stage IV	4.7	2.7-8.1	< 0.001