Anne-Marleen van Keulen1,2, Stijn Franssen1, Lydia G van der Geest3, Marieke T de Boer4, Minneke Coenraad5, Lydi M J W van Driel6, Joris I Erdmann7, Nadia Haj Mohammad8, Lara Heij9,10,11, Heinz-Josef Klümpen12, Eric Tjwa13, Liselot Valkenburg-van Iersel14, Joanne Verheij15, Bas Groot Koerkamp1, Pim B Olthof1,7. 1. Department of Surgery, Erasmus MC Cancer Institute, Rotterdam, the Netherlands. 2. Department of Surgery, Reinier de Graaf Gasthuis, Delft, the Netherlands. 3. Department of Research, Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, the Netherlands. 4. Department of Surgery, University Medical Center Groningen, Groningen, the Netherlands. 5. Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, the Netherlands. 6. Department of Gastroenterology, Erasmus Medical Center, Rotterdam, the Netherlands. 7. Department of Surgery, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands. 8. Department of Medical Oncology, University Medical Center Utrecht/ Regional Academic Cancer Center Utrecht, Utrecht University, Utrecht, the Netherlands. 9. Institute of Pathology, University Hospital RWTH Aachen, Aachen, Germany. 10. Visceral and Transplant Surgery, University Hospital RWTH Aachen, Aachen, Germany. 11. NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands. 12. Department of Medical Oncology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands. 13. Department of Gastroenterology, Radboud University Medical Center, Nijmegen, the Netherlands. 14. Department of Internal Medicine, Division of Medical Oncology, GROW-School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, the Netherlands. 15. Department of Pathology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands.
Abstract
BACKGROUND: Perihilar cholangiocarcinoma (pCCA) is a rare tumour that requires complex multidisciplinary management. All known data are almost exclusively derived from expert centres. This study aimed to analyse the outcomes of patients with pCCA in a nationwide cohort. METHODS: Data on all patients diagnosed with pCCA in the Netherlands between 2010 and 2018 were obtained from the Netherlands Cancer Registry. Data included type of hospital of diagnosis and the received treatment. Outcomes included the type of treatment and overall survival. RESULTS: A total of 2031 patients were included and the median overall survival for the overall cohort was 5.2 (95% CI 4.7-5.7) months. Three-hundred-ten (15%) patients underwent surgical resection, 271 (13%) underwent palliative systemic treatment, 21 (1%) palliative local anti-cancer treatment and 1429 (70%) underwent best supportive care. These treatments resulted in a median overall survival of 29.6 (95% CI 25.2-34.0), 12.2 (95% CI 11.0-13.3), 14.5 (95%CI 8.2-20.8) and 2.9 (95% CI 2.6-3.2) months respectively. Resection rate was 13% in patients who were diagnosed in non-academic and 32% in academic centres (P < .001), which resulted in a survival difference in favour of academic centres. Median overall survival was 9.7 (95% CI 7.7-11.7) months in academic centres compared to 4.9 (95% CI 4.3-5.4) months in non-academic centres (P < .001). CONCLUSIONS: In patients with pCCA, resection rate and overall survival were higher for patients who were diagnosed in academic centres. These results show population-based outcomes of pCCA and highlight the importance of regional collaboration in the treatment of these patients.
BACKGROUND: Perihilar cholangiocarcinoma (pCCA) is a rare tumour that requires complex multidisciplinary management. All known data are almost exclusively derived from expert centres. This study aimed to analyse the outcomes of patients with pCCA in a nationwide cohort. METHODS: Data on all patients diagnosed with pCCA in the Netherlands between 2010 and 2018 were obtained from the Netherlands Cancer Registry. Data included type of hospital of diagnosis and the received treatment. Outcomes included the type of treatment and overall survival. RESULTS: A total of 2031 patients were included and the median overall survival for the overall cohort was 5.2 (95% CI 4.7-5.7) months. Three-hundred-ten (15%) patients underwent surgical resection, 271 (13%) underwent palliative systemic treatment, 21 (1%) palliative local anti-cancer treatment and 1429 (70%) underwent best supportive care. These treatments resulted in a median overall survival of 29.6 (95% CI 25.2-34.0), 12.2 (95% CI 11.0-13.3), 14.5 (95%CI 8.2-20.8) and 2.9 (95% CI 2.6-3.2) months respectively. Resection rate was 13% in patients who were diagnosed in non-academic and 32% in academic centres (P < .001), which resulted in a survival difference in favour of academic centres. Median overall survival was 9.7 (95% CI 7.7-11.7) months in academic centres compared to 4.9 (95% CI 4.3-5.4) months in non-academic centres (P < .001). CONCLUSIONS: In patients with pCCA, resection rate and overall survival were higher for patients who were diagnosed in academic centres. These results show population-based outcomes of pCCA and highlight the importance of regional collaboration in the treatment of these patients.
Authors: David M de Jong; Jeska A Fritzsche; Amber S Audhoe; Suzanne S L Yi; Marco J Bruno; Rogier P Voermans; Lydi M J W van Driel Journal: Cancers (Basel) Date: 2022-04-21 Impact factor: 6.639