Trends in Incidence and Factors Affecting Survival of Patients With Cholangiocarcinoma in the United States

Abstract

Cholangiocarcinoma (CCA) includes cancers arising from the intrahepatic and extrahepatic bile ducts. The etiology and pathogenesis of CCA remain poorly understood. This is the first study investigating both incidence patterns of CCA from 1973 through 2012 and demographic, clinical, and treatment variables affecting survival of patients with CCA. Using the SEER database, age-adjusted incidence rates were evaluated from 1973-2012 using SEER*Stat software. A retrospective cohort of 26,994 patients diagnosed with CCA from 1973-2008 was identified for survival analysis. Cox proportional hazards models were used to perform multivariate survival analysis. Overall incidence of CCA increased by 65% from 1973-2012. Extrahepatic CCA (ECC) remained more common than intrahepatic CCA (ICC), whereas the incidence rates for ICC increased by 350% compared with a 20% increase seen with ECC. Men belonging to non-African American and non-Caucasian ethnicities had the highest incidence rates of CCA. This trend persisted throughout the study period, although African Americans and Caucasians saw 50% and 59% increases in incidence rates, respectively, compared with a 9% increase among other races. Median overall survival (OS) was 8 months in patients with ECC compared with 4 months in those with ICC. Our survival analysis found Hispanic women to have the best 5-year survival outcome (<.0001). OS diminished with age (<.0001), and ECC had better survival outcomes compared with ICC (<.0001). Patients who were married, were nonsmokers, belonged to a higher income class, and underwent surgery had better survival outcomes compared with others (<.0001). This is the most up-to-date study of CCA from the SEER registry that shows temporal patterns of increasing incidence of CCA across different races, sexes, and ethnicities. We identified age, sex, race, marital status, income, smoking status, anatomic location of CCA, tumor grade, tumor stage, radiation, and surgery as independent prognostic factors for OS in patients with CCA.

Attenuation of CD47-SIRPα Signal in Cholangiocarcinoma Potentiates Tumor-Associated Macrophage-Mediated Phagocytosis and Suppresses Intrahepatic Metastasis

“…Cholangiocarcinoma (CCA) is a cancer of liver, arising from bile duct epithelia. It is a rare cancer worldwide, but increasing incidences have been observed [9] , [10] . CCA is a major health problem in Thailand, where the highest incidences and mortalities are documented [11] .…”

Postbiliary drainage rates of cholangitis are impacted by procedural technique for patients with supra‐ampullary cholangiocarcinoma: A SEER‐Medicare analysis

“…Because surgical resection of cholangiocarcinoma has known implications for outcomes, including infectious complications, patients were stratified by resection status (postdrainage resection cohort and no postdrainage resection cohort). 3 This was accomplished using specified CPT codes (Table S1). Display of specific event values for any results with a patient sample size less than 11 was suppressed in accordance with the SEER-Medicare data user agreement.…”

“…Cholangiocarcinoma is a rare malignancy with an annual incidence of 1.02 cases per 100 000 patients in the United States, and a median survival of only 7 months . Patients with cholangiocarcinoma commonly present with obstructive jaundice and frequently require biliary drainage for symptom palliation or for presurgical drainage of the remnant liver . Previous studies have focused specifically on defining the best technical approach to biliary drainage by comparing percutaneous transhepatic biliary drainage (PTBD) to endoscopic biliary drainage (EBD).…”

The Advancement of Long Non-Coding RNAs in Cholangiocarcinoma Development

“…In contrast, in Europe the morbidity ranges from 0.45/100,000 to 3.36/100,000 [2]. Recently, the incidence of CCA tends to show a worldwide rise, especially ICC [3][4][5][6]. In US, ICC age-adjusted incidence rate increased from 1.42 to 1.82/100,000 in males and from 0.98 to 1.45 in females between 1999 and 2013 [8].…”