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. 2021 Aug;41(8):1945-1953.
doi: 10.1111/liv.14856. Epub 2021 Mar 12.

Nationwide treatment and outcomes of perihilar cholangiocarcinoma

Anne-Marleen van Keulen  1   2 , Stijn Franssen  1 , Lydia G van der Geest  3 , Marieke T de Boer  4 , Minneke Coenraad  5 , Lydi M J W van Driel  6 , Joris I Erdmann  7 , Nadia Haj Mohammad  8 , Lara Heij  9   10   11 , Heinz-Josef Klümpen  12 , Eric Tjwa  13 , Liselot Valkenburg-van Iersel  14 , Joanne Verheij  15 , Bas Groot Koerkamp  1 , Pim B Olthof  1   7 ; Dutch Hepatocellular & Cholangiocarcinoma Group (DHCG)
Affiliations

Nationwide treatment and outcomes of perihilar cholangiocarcinoma

Anne-Marleen van Keulen et al. Liver Int. 2021 Aug.

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.

Keywords: cholangiocarcinoma; klatskin tumour; treatment outcome.

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Conflict of interest statement

The authors report no relevant funding and no conflicts of interest. The need for ethical approval and individual informed consent was waived by the ethics committee. Permission to reproduce material from other sources is not applicable.

Figures

FIGURE 1
FIGURE 1
Overall survival according to (A) age, (B) gender, (C) metastasis at presentation and (D) socio‐economic state. Depicted below the graphs are the numbers at risk at 0, 24 and 48 months
FIGURE 2
FIGURE 2
Overall survival according to (A) treatment and (B) hospital of diagnosis. Depicted below the graphs are the numbers at risk
See this image and copyright information in PMC

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