Aimen Al Mahjoub1,2,3, Véronique Bouvier1,4,3, Benjamin Menahem1,2,3, Céline Bazille5, Audrey Fohlen6,7, Arnaud Alves1,2,3, Andrea Mulliri1,2, Guy Launoy1,4,3, Jean Lubrano1,2,3. 1. Departement of Calvados, Lower-Normandy, UMR 1086 INSERM Anticipe, François BACLESSE Center. 2. Departments of Digestive Surgery. 3. Departement of Calvados, Medical University of Caen. 4. Departement of Calvados, Lower-Normandy, Digestive Cancer Registry of Calvados, University Hospital of Caen. 5. Histopathology. 6. Radiology, University Hospital of Caen. 7. Departement of Calvados, University of Caen, CEA, CNRS, ISTCT/CERVOxy group, Caen, France.
Abstract
OBJECTIVES: The objective of this study was to investigate the differences between cholangiocarcinoma (CC) subtypes in terms of incidence rate, clinical presentation, management and survival by applying a stable anatomical classification in a population-based study. PATIENTS AND METHODS: Cancer data for the period 2000-2012 were obtained from a specialized digestive cancer registry in the Department of Calvados, France. Patients' files were checked, and the diagnosis was verified by two hepatobiliary surgeons. This approach prevents classifying perihilar cholangiocarcinoma (PHCC) as intrahepatic cholangiocarcinoma (ICC), thereby allowing an accurate estimation of their respective epidemiological characteristics. RESULTS: A total of 320 patients with CC were included. ICC represented 41% (130), whereas PHCC and distal cholangiocarcinoma represented 36 (116) and 23% (74), respectively. The mean age at the time of diagnosis differed significantly between the three subtypes (P<0.05). ICC was discovered accidently more frequently than PHCC, which was associated significantly with clinical symptoms. No change in the incidence or survival rates of CC subtypes were noticed, except for PHCC, in which female individuals had a significantly shorter median and 5-year survival rate of 0% (P<0.05). CONCLUSION: The frequency of PHCC is overestimated in the literature. The anatomical reclassification of CC subtypes shows the stability of their incidence and survival rates. Considering ICC and PHCC as two different entities implies the need to assign a specific topographic code for PHCC.
OBJECTIVES: The objective of this study was to investigate the differences between cholangiocarcinoma (CC) subtypes in terms of incidence rate, clinical presentation, management and survival by applying a stable anatomical classification in a population-based study. PATIENTS AND METHODS: Cancer data for the period 2000-2012 were obtained from a specialized digestive cancer registry in the Department of Calvados, France. Patients' files were checked, and the diagnosis was verified by two hepatobiliary surgeons. This approach prevents classifying perihilar cholangiocarcinoma (PHCC) as intrahepatic cholangiocarcinoma (ICC), thereby allowing an accurate estimation of their respective epidemiological characteristics. RESULTS: A total of 320 patients with CC were included. ICC represented 41% (130), whereas PHCC and distal cholangiocarcinoma represented 36 (116) and 23% (74), respectively. The mean age at the time of diagnosis differed significantly between the three subtypes (P<0.05). ICC was discovered accidently more frequently than PHCC, which was associated significantly with clinical symptoms. No change in the incidence or survival rates of CC subtypes were noticed, except for PHCC, in which female individuals had a significantly shorter median and 5-year survival rate of 0% (P<0.05). CONCLUSION: The frequency of PHCC is overestimated in the literature. The anatomical reclassification of CC subtypes shows the stability of their incidence and survival rates. Considering ICC and PHCC as two different entities implies the need to assign a specific topographic code for PHCC.
Authors: Nina Barner-Rasmussen; Eero Pukkala; Kishor Hadkhale; Martti Färkkilä Journal: United European Gastroenterol J Date: 2021-09-17 Impact factor: 4.623