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. 2023 May 31;27(2):151-157.
doi: 10.14701/ahbps.22-090. Epub 2023 Jan 2.

Survival analysis of extrahepatic cholangiocarcinoma based on surveillance, epidemiology, and end results database

Hassam Ali  1 , Joshua Zweigle  1 , Pratik Patel  2 , Brandon Tedder  1 , Rafeh Khan  3 , Saurabh Agrawal  4
Affiliations

Survival analysis of extrahepatic cholangiocarcinoma based on surveillance, epidemiology, and end results database

Hassam Ali et al. Ann Hepatobiliary Pancreat Surg. .

Abstract

Backgrounds/aims: Cholangiocarcinoma (CCA) can be classified as intrahepatic CCA or extrahepatic CCA (eCCA). We intended to analyze and reports the survival outcomes for eCCA.

Methods: Surveillance, epidemiology, and end results (SEER) registry, site recode C24.0, was used to select cases of eCCA from 2000 to 2018. Patients with incomplete data or ages <18 years were excluded.

Results: Male (52.69%) and White race (77.99%) predominated. Compared with 2000-2006, survival increased in 2013 (adjusted hazard ratio [HRadj]: 0.68, 95% confidence interval [CI] 0.58-0.70; p < 0.01). Surgery with chemoradiotherapy (HRadj: 0.69, 95% CI 0.60-0.7; p < 0.01) and surgery with chemotherapy (HRadj: 0.72, 95% CI 0.62-0.83; p < 0.01) improved survival over surgery alone. Compared with surgery without lymph node (LN) removal, surgery of four or more regional LN reduced the risk of death by 58% (HRadj: 0.42, 95% CI 0.36-0.51; p < 0.01). Compared with patients without surgery, patients who underwent bile duct excision (HRadj: 0.82, 95% CI 0.72-0.94; p < 0.01), simple or extended lobectomy (HRadj: 0.85, 95% CI 0.75-0.95; p = 0.009), and hepatectomy (HRadj: 0.80, 95% CI 0.72-0.88; p < 0.01) significantly improved survival. Patients with distal CCA had a 17% higher survival than perihilar CCA (HRadj: 0.83, 95% CI 0.74-0.92; p < 0.01) and LN dissection was equally beneficial for both subgroups (p < 0.01).

Conclusions: Surgery with chemoradiotherapy has a proven increase in the 5-year survival of the eCCA. LN resection, bile duct excision, lobectomy, and hepatectomy have better outcomes.

Keywords: Bile duct neoplasms; Bile ducts, extrahepatic; Cholangiocarcinoma; Lymph nodes; Survival analysis.

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Conflict of interest statement

CONFLICT OF INTEREST

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1
Kaplan–Meier curves for survival based on therapy (p < 0.01).
Fig. 2
Fig. 2
Kaplan–Meier curves for survival based on lymph node resection during surgery (p < 0.01).
Fig. 3
Fig. 3
Kaplan–Meier curves for survival based on perihilar cholangiocarcinomas (CCA) or distal CCA (p < 0.01).
See this image and copyright information in PMC

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