Temporal trends in liver-directed therapy of patients with intrahepatic cholangiocarcinoma in the United States: a population-based analysis.

Abstract:

BACKGROUND AND OBJECTIVES:Data on outcomes after liver-directed therapy for intrahepatic cholangiocarcinoma (ICC) are limited due to the rarity of the disease. We sought to define overall utilization and temporal trends of liver-directed therapy for ICC. METHODS:We identified 5,388 patients with ICC using the Surveillance Epidemiology and End Results (SEER) database between 1983 and 2010. Patients were characterized based on the type of liver-directed therapy received: surgical resection, ablation therapy, and radiation therapy. RESULTS:The majority of patients did not undergo liver-directed therapy (n = 4,156, 77.1%). Among those undergoing liver-directed therapy, surgical resection was most commonly performed (n = 672, 54.5%) and its utilization increased threefold over time (P = 0.001). The use of ablation therapy alone was used in 5.2% of patients and increased nearly sixfold over time (P = 0.39) whereas the use of radiation therapy alone decreased by nearly half (P < 0.001). Overall median survival was 10 months. Poor predictors of survival include tumor-based factors such as regional and distant disease, as well as poorly differentiated and large tumors (>5 cm). CONCLUSION:There was a moderate improvement in overall survival in patients with ICC between 1983 and 2010. The majority of patients with ICC are not undergoing liver-directed therapy. Among those who do undergo liver-directed therapy, the use of ablation therapy and surgery are increasing with nearly three in five patients undergoing resection.

journal_name

J Surg Oncol

authors

Amini N,Ejaz A,Spolverato G,Kim Y,Herman JM,Pawlik TM

doi

10.1002/jso.23605

subject

Has Abstract

pub_date

2014-08-01 00:00:00

pages

163-70

issue

2

eissn

0022-4790

issn

1096-9098

journal_volume

110

pub_type

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