Ampulla of Vater: Morphologic, Clinical, Survival, and Second Colon Primary Cancers Based on 5,625 Cases from the SEER Program
J Albores-Saavedra, K Batich, AM Schwartz, DE Henson. Instituto Nacional de Ciencias Medicas y Nutricion, Mexico City, Mexico; George Washington University Cancer Institute, Washington, DC; George Washington University Medical Center, Washington, DC
Background: Cancers of the ampulla have been infrequently studied, especially at a population level. Herein, we report the epidemiologic and morphological characteristics of cancer of the ampulla of Vater and its relationship with primary carcinomas arising in the colon.
Design: In SEER, all patients with a diagnosis of carcinoma of the ampulla were identified between 1973 and 2005. The demographic features, five-year survival rates according to stage, grade, and histologic tumor type, distribution of histological types, and frequency of a primary colon cancer preceding or following the development of the ampullary cancer were compared.
Results: A total of 5,625 cases of ampullary cancer were identified. Ampullary cancers have increased annually since 1973. In both blacks and whites, the disease is more common in men than in women. Adenocarcinomas, NOS comprised 65% of histologic types. Five-year relative survival depends on stage of disease, grade, and histological tumor type. Papillary carcinomas and carcinomas arising in adenomas had a significantly more favorable survival than other types. 10% of patients with ampullary cancer had a preceding primary cancer in another site. Of 571,304 cases of primary colorectal cancer, 134 developed a second primary in the ampulla. Twelve patients were between 15 and 30 years of age. Of 5,625 patients with primary cancer of the ampulla, 59 had second primary cancers in the colon or rectum.
Conclusions: The histological type, grade, co-existing adenoma, and stage serve as prognostic factors. The location of either first or second primary cancers in the colon or rectum associated with cancers in the ampulla followed the frequency distribution of all primary colon and rectal cancers seen in all patients.
Monday, March 9, 2009 1:00 PM
Poster Session II # 88, Monday Afternoon