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. 2023 Jul;12(13):14094-14103.
doi: 10.1002/cam4.6063. Epub 2023 May 22.

Characteristics and clinical outcomes in young-onset cholangiocarcinoma

Sarah Reddy  1 , Suleyman Yasin Goksu  1   2 , Nina N Sanford  3 , Radhika Kainthla  2 , David Hsiehchen  2 , Aravind Sanjeevaiah  2 , Amy L Jones  2 , Georgios Karagkounis  4 , Salwan Al Mutar  2 , Chul Ahn  5 , Muhammad S Beg  1   6 , Syed M Kazmi  2
Affiliations

Characteristics and clinical outcomes in young-onset cholangiocarcinoma

Sarah Reddy et al. Cancer Med. 2023 Jul.

Abstract

Background: While the incidence of cholangiocarcinoma is rising, little is known about young-onset disease. We compared clinical characteristics and outcomes between patients with young-onset cholangiocarcinoma, diagnosed between the ages of 18 and <50 years, and patients with typical-onset cholangiocarcinoma, diagnosed at age 50 years or greater.

Methods: We used the National Cancer Database to identify patients with young-onset cholangiocarcinoma (n = 2520) and typical-onset cholangiocarcinoma (n = 23,826). We compared the frequency of demographic and clinical characteristics between the two groups. We compared overall survival between the two groups using multivariable Cox regression analysis after adjusting for age, gender, race/ethnicity, comorbidity, facility type, tumor location, tumor stage, surgical status, and receipt of radiotherapy, chemotherapy and surgery.

Results: When compared to patients with typical-onset disease (median age 68 years), patients with young-onset cholangiocarcinoma (median age 44 years) were more likely to be non-White (35.0% vs. 27.4%, p < 0.01), and had lower overall comorbidity burden. Patients with young-onset disease had a greater proportion of intrahepatic cholangiocarcinoma (56.0% vs. 45.5%, p < 0.001) and stage IV disease (50.5% vs. 43.5%, p < 0.001). Younger patients were more likely than typical-onset patients to receive definitive surgery (30.9% vs. 25.0%, p < 0.001), radiation (27.7% vs. 19.6%, p < 0.001) and chemotherapy (73.1% vs. 50.1%, p < 0.001). In adjusted analyses, patients with young-onset disease had a 15% decreased risk of death, compared with patients with typical-onset disease (HR 0.85 [95% CI 0.80-0.89], p < 0.001).

Conclusions: Patients with young-onset cholangiocarcinoma may represent a demographically and clinically distinct group from those with more typical-onset disease.

Keywords: age of onset; cholangiocarcinoma; hepatobiliary neoplasms; treatment outcome.

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Conflict of interest statement

Reddy, Goksu, Sanford, Kainthla, Hsiechen, Sanjeevaiah, Jones, Karagkounis, Salwan al Mutar, Ahn, Beg: None Reported. Kazmi: Johnson and Johnson.

Figures

FIGURE 1
FIGURE 1
Flow chart of study population section.
FIGURE 2
FIGURE 2
Overall survival among patients with young‐onset cholangiocarcinoma versus typical‐onset cholangiocarcinoma.
FIGURE 3
FIGURE 3
Overall survival among patients who received definitive surgical treatment for cholangiocarcinoma, and among patients with intrahepatic and extrahepatic cholangiocarcinoma.
See this image and copyright information in PMC

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