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Int J Cancer. 2018 Jul 15;143(2):324-332. doi: 10.1002/ijc.31322. Epub 2018 Mar 5.

Survival of patients with hepatobiliary tract and duodenal cancer sites in Germany and the United States in the early 21st century.

Author information

Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany.
Cancer Registry of Rhineland-Palatinate, Institute of Medical Biostatistics, Epidemiology, and Informatics, Mainz, Germany.
Saarland Cancer Registry, Saarbrücken, Germany.
Cancer Registry of Schleswig-Holstein, Lübeck, Germany.
Bremen Cancer Registry, Leibniz-Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.
Cancer Registry of Lower Saxony, Oldenburg, Germany.
Division of Preventive Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany.
German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany.


Hepatobiliary tract cancers (HBTCs) are a heterogeneous group of cancers with high mortality. Because most of these cancers, with the exception of hepatocellular carcinoma (HCC), are rare, few data are available concerning the population level survival expectations of patients with HBTC. Here, we describe survival of patients with HBTC in Germany with comparison to survival in the US. Therefore, data were extracted from 12 databases in Germany and the Surveillance, Epidemiology and End Results (SEER13) database in the US. Period analysis and modeled period analysis were used to calculate 5-year relative survival estimates for patients with HBTC diagnosed from 1997 to 2013. HCC was the most common HBTC in each database, accounting for over 1/3 of HBTC in Germany and about half of cases in the US. Overall age adjusted 5-year relative survival for HBTC in 2006-2013 was 19.1% in Germany and 20.6% in the US. Five-year relative survival increased by 3.8% units in Germany and 4.5% units in the US between 2002-2005 and 2010-2013. Five-year relative survival for individual types of HBTC ranged from 9.8% in Germany and 2.9% in the US for not otherwise specified biliary tract cancers to 44.4% and 50.1%, respectively, in Germany and the US for duodenal cancers. In conclusion, survival for HBTC remains poor in both Germany and the US, although a small increase in survival in the past decade was observed. Further work to find better treatment options for HBTC is needed to improve survival.


cancer; hepatobiliary tract; population-based; survival

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