Cancer of the ampulla of Vater: results of a 20-year population-based study

BACKGROUND SETTING RESULTSAge-standardized incidence rates were 3.8 per 1 000 000 inhabitants in men and 2.7 per 1 000 000 inhabitants in women. Incidence increased over time in men from 1.9 during the first period (1976-1980) to 5.9 during the last period (1991 - 1995). In women, incidence rates remained stable. A resection for cure was performed in 52 cases (48.1%). Overall, 9.9% of these cancers were classified TNM stage I and 54.1% stage IV. There was no significant variation in treatment modalities and in stage at diagnosis over the study period. The overall operative mortality rate was 7.5%. Relative survival rates were 58.9% at 1 year, 30.9% at 3 years and 20.9% at 5 years. Five-year relative survival rates varied from 72.8% in TNM stage I cancers to 6.6% in TNM stage IV cancers. Age, treatment procedure and stage at diagnosis significantly influenced the prognosis of cancer of the ampulla of Vater. In a multivariate analysis, stage at diagnosis remained the major prognostic factor (P < 0.01). CONCLUSIONSAlthough its incidence is increasing in men, cancer of the ampulla of Vater remains a rare tumour in both sexes. No improvements in the management and care of patients have been achieved. Further studies are needed to enhance the understanding of this cancer. Eur J Gastroenterol Hepatol 12:75-79 © 2000 Lippincott Williams & WilkinsEuropean Journal of Gastroenterology & Hepatology 2000, 12:75-79