Treatment and overall survival of four types of non-metastatic periampullary cancer: nationwide population-based cohort study

Evelien J.M. de Jong, Lydia G. van der Geest, the Dutch Pancreatic Cancer Group, Marc G. Besselink, Stefan A.W. Bouwense, Jeroen Buijsen, C. H.C. Dejong, Bas G. Koerkamp, Lara R. Heij, Ignace H.J.T. de Hingh, Chantal Hoge, Geert Kazemier, Hanneke W.M. van Laarhoven, Vincent E. de Meijer, Martijn W.J. Stommel, Vivianne C.G. Tjan-Heijnen, Liselot B.J. Valkenburg-van Iersel, Johanna W. Wilmink, Sandra M.E. Geurts, Judith de Vos-Geelen*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

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.

Original languageEnglish
Pages (from-to)1433-1442
Number of pages10
JournalHPB
Volume24
Issue number9
DOIs
Publication statusPublished - Sept 2022

Bibliographical note

Funding Information:
SG reports grants from Roche, grants from Pfizer, grants from Novartis, grants from Eisai, grants from Lilly. All outside the submitted work; HVL reports grants and non-financial support from BMS, grants and non-financial support from Celgene, grants and non-financial support from Lilly, grants and non-financial support from Nordic, grants and non-financial support from Servier, grants from Bayer, grants from Merck Serono, grants from MSD, grants from Philips. All outside the submitted work;

Funding Information:
The authors declare the following financial interests/personal relationships which may be considered as potential competing interests:JDV has served as a consultant for Amgen, AstraZeneca, MSD, Pierre Fabre, and Servier, and has received institutional research funding from Servier. All outside the submitted work.

Funding Information:
VM reports a VENI grant by the Netherlands Organization for Scientific Research (NWO; grant #09150161810030) and a grant from the Dutch Ministry of Economic Affairs (Health ∼ Holland Public Private Partnership grant #PPP-2019-024). All outside the submitted work; IDH received grants from Roche and RanD Biotechnology. All outside the submitted work;

Funding Information:
The authors thank the registration team of the Netherlands Comprehensive Cancer Organisation (IKNL) for the collection of data for the Netherlands Cancer Registry as well as IKNL staff for scientific advice.

Funding Information:
VT-H reports grants and personal fees from Roche, grants and personal fees from Novartis, grants and personal fees from Pfizer, grants and personal fees from Lilly, personal fees from Accord Healthcare, grants from AstraZeneca, grants from Eisai, grants from Daiichi Sankyo. All outside the submitted work; LV-VI reports non-financial support from Servier, non-financial support from Pierre Fabre, non-financial support from Roche. All outside the submitted work; JW reports grants and non-financial support from Servier, non-financial support from MSD, non-financial support from AstraZeneca, grants and non-financial support from Celgene, grants from Halozyme, grants from Merck, grants from Roche, grants from Pfizer, grants from Amgen, grants from Novartis. All outside the submitted work;

Publisher Copyright:
© 2022 The Author(s)

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