TY - JOUR
T1 - Treatment and overall survival of four types of non-metastatic periampullary cancer
T2 - nationwide population-based cohort study
AU - de Jong, Evelien J M
AU - van der Geest, Lydia G
AU - Besselink, Marc G
AU - Bouwense, Stefan A W
AU - Buijsen, Jeroen
AU - Dejong, C H C
AU - Koerkamp, Bas G
AU - Heij, Lara R
AU - de Hingh, Ignace H J T
AU - Hoge, Chantal
AU - Kazemier, Geert
AU - van Laarhoven, Hanneke W M
AU - de Meijer, Vincent E
AU - Stommel, Martijn W J
AU - Tjan-Heijnen, Vivianne C G
AU - Valkenburg-van Iersel, Liselot B J
AU - Wilmink, Johanna W
AU - Geurts, Sandra M E
AU - de Vos-Geelen, Judith
AU - Dutch Pancreatic Cancer Group
N1 - Copyright © 2022 The Author(s). Published by Elsevier Ltd.. All rights reserved.
PY - 2022/9
Y1 - 2022/9
N2 - BACKGROUND: Periampullary adenocarcinoma consists of pancreatic adenocarcinoma (PDAC), distal cholangiocarcinoma (DC), ampullary cancer (AC), and duodenal adenocarcinoma (DA). The aim of this study was to assess treatment modalities and overall survival by tumor origin.METHODS: Patients diagnosed with non-metastatic periampullary cancer in 2012-2018 were identified from the Netherlands Cancer Registry. OS was studied with Kaplan-Meier analysis and multivariable Cox regression analyses, stratified by origin.RESULTS: Among the 8758 patients included, 68% had PDAC, 13% DC, 12% AC, and 7% DA. Resection was performed in 35% of PDAC, 56% of DC, 70% of AC, and 59% of DA. Neoadjuvant and/or adjuvant therapy was administered in 22% of PDAC, 7% of DC, 7% of AC, and 12% of DA. Three-year OS was highest for AC (37%) and DA (34%), followed by DC (21%) and PDAC (11%). Adjuvant therapy was associated with improved OS among PDAC (HR = 0.62; 95% CI 0.55-0.69) and DC (HR = 0.69; 95% CI 0.48-0.98), but not AC (HR = 0.87; 95% CI 0.62-1.22) and DA (HR = 0.85; 95% CI 0.48-1.50).CONCLUSION: This retrospective study identified considerable differences in treatment modalities and OS between the four periampullary cancer origins in daily clinical practice. An improved OS after adjuvant chemotherapy could not be demonstrated in patients with AC and DA.
AB - BACKGROUND: Periampullary adenocarcinoma consists of pancreatic adenocarcinoma (PDAC), distal cholangiocarcinoma (DC), ampullary cancer (AC), and duodenal adenocarcinoma (DA). The aim of this study was to assess treatment modalities and overall survival by tumor origin.METHODS: Patients diagnosed with non-metastatic periampullary cancer in 2012-2018 were identified from the Netherlands Cancer Registry. OS was studied with Kaplan-Meier analysis and multivariable Cox regression analyses, stratified by origin.RESULTS: Among the 8758 patients included, 68% had PDAC, 13% DC, 12% AC, and 7% DA. Resection was performed in 35% of PDAC, 56% of DC, 70% of AC, and 59% of DA. Neoadjuvant and/or adjuvant therapy was administered in 22% of PDAC, 7% of DC, 7% of AC, and 12% of DA. Three-year OS was highest for AC (37%) and DA (34%), followed by DC (21%) and PDAC (11%). Adjuvant therapy was associated with improved OS among PDAC (HR = 0.62; 95% CI 0.55-0.69) and DC (HR = 0.69; 95% CI 0.48-0.98), but not AC (HR = 0.87; 95% CI 0.62-1.22) and DA (HR = 0.85; 95% CI 0.48-1.50).CONCLUSION: This retrospective study identified considerable differences in treatment modalities and OS between the four periampullary cancer origins in daily clinical practice. An improved OS after adjuvant chemotherapy could not be demonstrated in patients with AC and DA.
U2 - 10.1016/j.hpb.2022.01.009
DO - 10.1016/j.hpb.2022.01.009
M3 - Article
C2 - 35135724
SN - 1365-182X
VL - 24
SP - 1433
EP - 1442
JO - HPB
JF - HPB
IS - 9
ER -