Cholangiocarcinoma: anatomical location-dependent clinical, prognostic, and genetic disparities

Hang, Hualian; Jeong, Seogsong; Meng, Sha; Kong, Defu; Xi, Zhen; Tong, Ying; Xia, Qiang

doi:10.21037/atm.2019.12.37

Cited by 14 publications

(17 citation statements)

References 24 publications

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“…These rates were different when classified only anatomically, when the highest survival rate in patients with DCCA was 65% at 1 year, 37.5% at 3 years, and 34.8% at 5 years, respectively. Our finding is contrast with what was found in a study by Hang and colleagues in 2019 which showing that the highest 5-year overall survival was found in ICCA (16.7%) followed by PCCA (16.4%) and DCCA (5.7%) [ 16 ]. The large difference of the 5-year survival rate among DCCA patients between this and our study, 5.7% versus 34.8%, could caused by various factors such as cause of the disease, cancer staging at time of surgery, surgical resectability, susceptibility to lymph node dissection, etc.…”

Section: Discussioncontrasting

confidence: 99%

“…The survival of resected and unresected DCCA patients in the Netherlands between 2009 and 2016, had a median overall survival of 10.4 months across all stages; 21.9 months for resected, 6.7 months for unresected nonmetastatic, and 3.6 months for metastatic DCCA with the P was < 0.001 [15]. In 2019, there was a study performed in 11, 710 CCA patients from Surveillance, Epidemiology, and End Results Cancer Registries (SEER) compared survival for ICCA, PCCA, and DCCA and found that 5-year overall survival was highest in ICCA (16.7%) followed by PCCA (16.4%) and DCCA (5.7%) [16].…”

Section: Introductionmentioning

confidence: 99%

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Survival after surgery among patients with cholangiocarcinoma in Northeast Thailand according to anatomical and morphological classification

et al. 2021

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Background Cholangiocarcinoma (CCA) has been categorized based on tumor location as intrahepatic (ICCA), perihilar (PCCA) or distal (DCCA), and based on the morphology of the tumor of the bile duct as mass forming (MF), periductal infiltrating (PI) or intraductal (ID). To date, there is limited evidence available regarding the survival of CCA among these different anatomical and morphological classifications. This study aimed to evaluate the survival rate and median survival time after curative surgery among CCA patients according to their anatomical and morphological classifications, and to determine the association between these classifications and survival. Methods This study included CCA patients who underwent curative surgery from the Cholangiocarcinoma Screening and Care Program (CASCAP), Northeast Thailand. The anatomical and morphological classifications were based on pathological findings after surgery. Survival rates of CCA and median survival time since the date of CCA surgery and 95% confidence intervals (CI) were calculated. Multiple cox regression was performed to evaluate factors associated with survival which were quantified by hazard ratios (HR) and their 95% CIs. Results Of the 746 CCA patients, 514 had died at the completion of the study which constituted 15,643.6 person-months of data recordings. The incidence rate was 3.3 per 100 patients per month (95% CI: 3.0–3.6), with median survival time of 17.8 months (95% CI: 15.4–20.2), and 5-year survival rate of 24.6% (95% CI: 20.7–28.6). The longest median survival time was 21.8 months (95% CI: 16.3–27.3) while the highest 5-year survival rate of 34.8% (95% CI: 23.8–46.0) occurred in the DCCA group. A combination of anatomical and morphological classifications, PCCA+ID, was associated with the longest median survival time of 40.5 months (95% CI: 17.9–63.0) and the highest 5-year survival rate of 42.6% (95% CI: 25.4–58.9). The ICCA+MF combination was associated with survival (adjusted HR: 1.45; 95% CI: 1.01–2.09; P = 0.013) compared to ICCA+ID patients. Conclusions Among patients receiving surgical treatment, those with PCCA+ID had the highest 5-year survival rate, which was higher than in groups classified by only anatomical characteristics. Additionally, the patients with ICCA+MF tended to have unfavorable surgical outcomes. Showed the highest survival association. Therefore, further investigations into CCA imaging should focus on patients with a combination of anatomical and morphological classifications.

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Section: Discussioncontrasting

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Survival after surgery among patients with cholangiocarcinoma in Northeast Thailand according to anatomical and morphological classification

et al. 2021

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“…[ 15 , 36 ] For instance, the chance of having surgery for patients with ECCA was 36–37%, while that for patients with ICCA was 18.5%, which was associated with the rate of distant metastasis (ECCA vs ICCA, 30% vs 43.5%). [ 37 ] In addition, we found that older patients (>=50 years) had worse survival than younger patients (<50 years) in both ECCA and ICCA, which may be somewhat associated with better tolerance of the operation itself and fewer complications in younger patients. [ 7 , 9 , 38 ] With regard to CCA in the T1 stage, we found that patients with ICCA had better survival than those with ECCA before or after performing PSM.…”

Section: Discussionmentioning

confidence: 89%

Analysis of metastasis and survival between extrahepatic and intrahepatic cholangiocarcinoma

et al. 2021

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To date, extrahepatic cholangiocarcinoma (ECCA) and intrahepatic cholangiocarcinoma (ICCA) have rarely been compared; therefore, we attempted to learn more about the rates of metastasis and survival in both ICCA and ECCA. Data of patients in the SEER database diagnosed with ICCA or ECCA were extracted to analyse the rate of metastasis and survival. Univariate and multivariate logistic regression analyses were performed to identify the risk factors for metastasis. Propensity score matching (PSM) was used to compare survival rates between ECCA and ICCA. Data from a total of 15,751 patients diagnosed with ICCA or ECCA were extracted to analyse the rate of metastasis. Metastasis was more common in ECCA than ICCA (42.62% vs. 31.46%, P < .05), while ICCA in the T1 stage had a lower rate of metastasis (25.35% vs. 30.61%, P < .05). Age, pathology grade, tumour size, lymph node metastasis and T stage were independent risk factors for metastasis in both ECCA and ICCA. There was an inverse correlation between age and metastasis in both ICCA and ECCA. Moreover, PSM demonstrated that patients with ECCA had a better prognosis than patients with ICCA. Patients with ICCA in the T1 stage had better survival than those with ECCA in the T1 stage. Our study was the first to compare the rates of metastasis and survival between ECCA and ICCA. We observed an inverse association between age and metastasis, that patients with ECCA had a better prognosis than patients with ICCA, and that patients with ECCA in the T1 stage had worse survival than patients with ICCA in the T1 stage.

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“…Combined hepatocellular and cholangiocarcinoma (CHC) account for 0.4-14.2% of primary hepatic malignancies (1,2), originate from hepatic progenitor cells (3) and show both hepatocytic and cholangiocytic differentiation (4,5). In contrast, intrahepatic cholangiocarcinoma (ICC) is the second most common hepatic malignancy after hepatocellular carcinoma (6) and histologically derived from the biliary epithelial cell.…”

Section: Introductionmentioning

confidence: 99%

Differentiation combined hepatocellular and cholangiocarcinoma from intrahepatic cholangiocarcinoma based on radiomics machine learning

Zhang¹,

Huang²,

Cao³

et al. 2020

Ann Transl Med

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Background: Combined hepatocellular and cholangiocarcinoma (CHC) and intrahepatic cholangiocarcinoma (ICC) are hard to identify in clinical practice preoperatively. This study looked to develop and confirm a radiomics-based model for preoperative differentiation CHC from ICC. Methods: The model was developed in 86 patients with ICC and 46 CHC, confirmed in 37 ICC and 20 CHC, and data were collected from January 2014 to December 2018. The radiomics scores (Radscores) were built from radiomics features of contrast-enhanced computed tomography in 12 regions of interest (ROI). The Radscore and clinical-radiologic factors were integrated into the combined model using multivariable logistic regression. The best-combined model constructed the radiomics-based nomogram, and the performance was assessed concerning its calibration, discrimination, and clinical usefulness. Results: The radiomics features extracted from tumor ROI in the arterial phase (AP) with preprocessing were selected to build Radscore and yielded an area under the curve (AUC) of 0.800 and 0.789 in training and validation cohorts, respectively. The radiomics-based model contained Radscore and 4 clinical-radiologic factors showed the best performance (training cohort, AUC =0.942; validation cohort, AUC =0.942) and good calibration (training cohort, AUC =0.935; validation cohort, AUC =0.931). Conclusions:The proposed radiomics-based model may be used conveniently to the preoperatively differentiate CHC from ICC.

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Cholangiocarcinoma: anatomical location-dependent clinical, prognostic, and genetic disparities

Cited by 14 publications

References 24 publications

Survival after surgery among patients with cholangiocarcinoma in Northeast Thailand according to anatomical and morphological classification

Survival after surgery among patients with cholangiocarcinoma in Northeast Thailand according to anatomical and morphological classification

Analysis of metastasis and survival between extrahepatic and intrahepatic cholangiocarcinoma

Differentiation combined hepatocellular and cholangiocarcinoma from intrahepatic cholangiocarcinoma based on radiomics machine learning

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