Temporal trends in liver‐directed therapy of patients with intrahepatic cholangiocarcinoma in the United States: A population‐based analysis. Issue 2 (27th March 2014)

• Record Type: Journal Article
• Authors: Amini, Neda; Ejaz, Aslam; Spolverato, Gaya; Kim, Yuhree; Herman, Joseph M.; Pawlik, Timothy M.
• Is Part Of: Journal of surgical oncology. Volume 110:Issue 2(2014:Aug. 01)
• Page Start: 163
• Page End: 170
• Publication Date: 2014-03-27
• Subjects: Cancer -- Surgery -- Periodicals; Neoplasms -- Periodicals; 616
• DOI: 10.1002/jso.23605
• Languages: English
• ISSNs: 0022-4790

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="jso23605-sec-0001" sec-type="section"> <title>Background and Objectives</title> <p>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.</p> </sec> <sec id="jso23605-sec-0002" sec-type="section"> <title>Methods</title> <p>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.</p> </sec> <sec id="jso23605-sec-0003" sec-type="section"> <title>Results</title> <p>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 (<italic>P</italic> = 0.001). The use of ablation therapy alone was used in 5.2% of patients and increased nearly sixfold over time (<italic>P</italic> = 0.39) whereas the use of radiation therapy alone decreased by nearly half (<italic>P</italic> < 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).</p> </sec> <sec id="jso23605-sec-0004" sec-type="section"> <title>Conclusion</title> <p>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. <italic>J. Surg. Oncol. 2014; 110:163–170</italic>. © 2014 Wiley Periodicals, Inc.</p> </sec> </abstract>