Ann Hepatobiliary Pancreat Surg.  2022 Aug;26(3):235-243. 10.14701/ahbps.21-173.

Changing incidence and survival of intrahepatic cholangiocarcinoma based on Surveillance, Epidemiology, and End Results Database (2000–2017)

• Ali H
• Tedder B
• Waqar SH
• Mohamed R
• Cate EL
• Ali E

• KMID: 2532639
• DOI: http://doi.org/10.14701/ahbps.21-173

Abstract

Backgrounds/Aims
Historically, the incidence and prognosis of patients diagnosed with intrahepatic cholangiocarcinoma (ICC) have been inadequately understood. Survival analysis in ICC has yet to be investigated in a population-based study.
Methods
We conducted a retrospective cohort study using the Surveillance, Epidemiology, and End Results Program (SEER) 18 Registry. Risk ratios were estimated via Poisson regression. Hazard ratios for 5-year survival were estimated using hierarchical Cox regression models.
Results
Males show a higher rate of age-adjusted ICC incidence. Blacks carried a decreased risk of ICC diagnosis than Whites, while Asians revealed a higher risk of ICC diagnosis when compared with Whites. The observed survival rates at 12, 36, and 60 months were 36.3%, 12.8%, and 8.1%, respectively. Compared with Whites, Blacks showed an increased risk of death (p < 0.01). Lymph node resection during surgery was associated with a 64.1% reduced risk of mortality (p < 0.01). A higher T stage at diagnosis was associated with poor survival (p < 0.01). Surgery combined with chemoradiotherapy, radiotherapy, or chemotherapy was associated with a reduced risk of mortality compared with nonsurgical interventions (p < 0.01).
Conclusions
ICC incidence has been increasing since 2000, especially in White males. The risk of ICC rises with age. Lymph node removal is associated with better survival. In recent years, survival had worsened, and surgical intervention improved survival compared with nonsurgical management.

Keyword

Lymphatic metastasis; Prognosis; Cholangiocarcinoma; SEER Program; Survival

Figure

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  Fig. 1 Trends of intrahepatic cholangiocarcinoma incidence rates, annual percentage changes. (A) Based on sex (SEER 2000–2017); (B) Based on race (SEER 2000–2017); (C) Based on age group (SEER 2000–2017). SEER, Surveillance, Epidemiology, and End Results Program.

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  Fig. 2 Kaplan–Meier curves of survival based on sex (p < 0.01).

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  Fig. 3 Kaplan–Meier curves of survival based on age group (p < 0.01).

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  Fig. 4 Kaplan–Meier curves of survival based on surgical intervention (p < 0.01).

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  Fig. 5 Kaplan–Meier curves of survival based on adjusted the sixth edition of the American Joint Committee on Cancer (AJCC) for cancer staging and diagnosis (p < 0.01).

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  Fig. 6 Kaplan–Meier curves of survival based on race (p < 0.01).

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  Fig. 7 Kaplan–Meier curves of survival based on year groups (p < 0.01).

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  Fig. 8 Kaplan–Meier curves of survival based on lymph node resection during surgery (p < 0.01).

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  Fig. 9 Kaplan–Meier curves of survival based on tumor grade on presentation (p < 0.01).

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