Cholangiocarcinoma miscoding in hepatobiliary centres

Selvadurai, Shaun; Mann, Kathy; Mithra, S.; Bridgewater, John; Malik, Hassan; Khan, Shahid A.

doi:10.1016/j.ejso.2020.09.039

Cited by 22 publications

(25 citation statements)

References 22 publications

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“…However, worldwide, ~90% of CCAs are extrahepatic. [1,53] In addition, even cases coded as iCCA could actually be eCCA cases given that studies in both the UK [54] and the USA [55] have demonstrated extensive misclassification of perihilar eCCA as iCCA, providing further support that the majority of these tumors included in our study are extrahepatic. That the use of estrogen-only MHT formulations was associated with a decreased risk of CCA in our study suggests that estrogen signaling acts through the ERβ pathway, producing an antiproliferative response in the extrahepatic bile duct.…”

Section: Discussionsupporting

confidence: 62%

Menopausal hormone therapy and risk of biliary tract cancers

et al. 2022

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Background and Aims Gallbladder cancer (GBC) has a female predominance, whereas the other biliary tract cancers (BTCs) have a male predominance, suggesting that sex hormones may be involved in carcinogenesis. We sought to evaluate the association between menopausal hormone therapy (MHT) and the risk of BTC in women. Approach and Results This nested case‐control study was conducted in the UK Clinical Practice Research Datalink. Cases diagnosed between 1990 and 2017 with incident primary cancers of the gallbladder (GBC), cholangiocarcinoma (CCA), ampulla of Vater (AVC), and mixed type were matched to 5 controls on birth year, diagnosis year, and years in the general practice using incidence density sampling. Conditional logistic regression was used to calculate ORs and 95% CIs for associations between MHT use and BTC type. The sample consisted of 1,682 BTC cases (483 GBC, 870 CCA, 105 AVC, and 224 mixed) and 8,419 matched controls with a mean age of 73 (SD, 11) years. Combined formulations (estrogen‐progesterone) were associated with an increased GBC risk (OR, 1.97; 95% CI, 1.08, 3.59). Orally administered MHT was associated with an increased GBC risk (OR, 2.28; 95% CI, 1.24, 4.17). Estrogen‐only formulations (OR, 0.59; 95% CI, 0.34, 0.93) and cream or suppository administrations (OR, 0.57; 95% CI, 0.34, 0.95) were associated with decreased CCA risk. The number of prescriptions, dose, duration of use, and time since last use were not associated with GBC or CCA risk. MHT use was not associated with risk of AVC or mixed cancer. Conclusions Combination MHT formulations and oral administrations were associated with increased GBC risk, whereas estrogen‐only formulations were associated with a lower CCA risk. MHT formulation and administration should be carefully considered when prescribing.

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Section: Discussionsupporting

confidence: 62%

Menopausal hormone therapy and risk of biliary tract cancers

et al. 2022

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“…Based on the anatomical origin, CCAs are classified as intrahepatic (iCCA), perihilar (pCCA), or distal (dCCA). 1,3 Although these subtypes are hypothesized to have different risk factors, pathobiology, clinical presentation, management, and prognosis, 1 large datasets defining these differences are limited. 4 Accordingly, a coherent international study to enhance granularity of the global clinical situation of CCA is pivotal to better understand the disease course, define the similarities and/or differences between CCA subtypes, describe outcomes after selected treatments, and identify challenges for future prospective analyses.…”

Section: Introductionmentioning

confidence: 99%

Cholangiocarcinoma landscape in Europe: Diagnostic, prognostic and therapeutic insights from the ENSCCA Registry

Izquierdo-Sánchez

Lamarca

Casta

et al. 2022

Journal of Hepatology

162

116

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“…ICD-O-2 classifications from SEER database resulted in 91% of pCCA being incorrectly classified as iCCAs, leading to an overestimation of iCCA incidence by 13% and underestimation of eCCA incidence by 15% [4]. The impact of misclassification of epidemiological understanding of CCAs has been demonstrated in further studies [18,28,29], and the rising iCCA and declining eCCA mortality rates in the west may be reflective of this misclassification.…”

Section: Misclassification and Codingmentioning

confidence: 97%

“…In a recent study from the UK, original clinical notes of cases coded as hepatobiliary carcinoma using WHO ICD-10 criteria (C22.1/Intrahepatic Bile Duct carcinoma, C24.0/Extrahepatic Bile Duct carcinoma, C23X/Malignant Neoplasm Gall Bladder, C22.0/Malignant Neoplasm Liver Cell Carcinoma) at three independent UK regional HepatoPancreatoBiliary centres over a 2 year period were reviewed by independent clinicians [18]. The agreed final diagnosis was compared to the originally allocated ICD-10 code.…”

Section: Misclassification and Codingmentioning

confidence: 99%