Trends in incidence and management of cancer of the ampulla of Vater
Trends in incidence and management of cancer of the ampulla of Vater
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DOI：
10.3748/wjg.v20.i29.10144
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发表时间：
2014-08-21
影响因子：
4.3
通讯作者：
Lepage, Come
中科院分区：
文献类型：
--
作者：
Rostain, Florian;Hamza, Samia;Lepage, Come
目的：提供在定义明确的法国人群中瓦特壶腹癌的发病率、治疗和存活率的趋势。方法：数据来自勃艮第基于人群的消化性癌症登记，时间跨度为34年。年龄标准化发病率是使用世界标准人口计算的。发病率的平均年变化使用泊松回归来估计。结果：男性和女性的年龄标化发病率分别为每100000人0.46和0.30。男性的发病率从0.26(1976-1984年)上升到0.58(2003-2009年)，女性的发病率保持稳定。手术切除治愈率为48.3%。这一比例在研究期间保持稳定。在根治性切除的病例中，行胰十二指肠切除术的占94.0%，行壶腹部切除术的占6.0%。共有50.8%的壶腹癌是在晚期诊断出来的。在整个研究期间，他们的比例保持稳定。总的1、5年相对生存率分别为60.2%和27.7%。相对存活率没有随着时间的推移而变化。治疗和确诊时的分期是最重要的生存决定因素。根治切除后的5年相对生存率为41.5%，姑息手术后为9.5%，对症治疗后为6.7%。在多因素分析中，只有确诊阶段对死亡风险有显著影响。结论：Vater壶腹癌仍然不常见，但在勃艮第男性中其发病率有所增加。诊断通常是在晚期，极大地恶化了预后。(C)2014百仕登出版集团有限公司，版权所有。
AIM: To provide trends in incidence, management and survival of cancer of the ampulla of Vater in a well-defined French population.METHODS: Data were obtained from the populationbased 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-standardized 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. 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 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 stage. Their proportion remained stable throughout the study period. The overall 1- and 5-year relative survival rates were 60.2% and 27.7%, 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. (C) 2014 Baishideng Publishing Group Inc. All rights reserved.