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Age-Standardized Incidence Rates of Liver Cancer, Hepatocellular Carcinoma and Intrahepatic and Extrahepatic Cholangiocarcinoma by Sex
Source publication
The term "cholangiocarcinoma" was originally used only for intrahepatic bile duct (adeno)carcinomas, but is now regarded as inclusive of intrahepatic, perihilar, and distal extrahepatic tumors of the bile ducts. A rise in incidence of intrahepatic cholangiocarcinoma has been recently reported in Western countries but comparatively little is known a...
Contexts in source publication
Context 1
... found substantial geographical variability in incidence of CCA within the Asian populations for the period 1998-2002, as shown in Table 1. The highest Comparison of Incidence of Intrahepatic and Extrahepatic Cholangiocarcinoma -Focus on East and South-eastern Asia- rates of IHCCA are from Khon Kaen, Thailand (71.3 per 100,000 in men and 31.6 in women). ...
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Aim:
The incidence of pancreaticobiliary maljunction is thought to approximate 1:100,000 within Western populations. We aimed to study the significance of pancreaticobiliary maljunction in biliary tract malignancies.
Methods:
Medical records and magnetic resonance cholangiopancreatography images of 252 consecutive patients treated for biliary ma...
Citations
... Regardless of kind, it is unquestionably acknowledged that cholangiocarcinoma is a fatal cancer that typically manifests late, is famously difficult to identify, and is associated with a very high fatality rate. The occurrence of intrahepatic cholangiocarcinoma is increasing around the globe (6)(7)(8)(9)(10). The reason for this increase is not clear, although it could be related to an interplay between predisposing genetic factors and environmental triggers. ...
Background
Clinically, the diagnosis and treatment of cholangiocarcinoma are generally different according to the location of occurrence, and the studies rarely consider the differences between different pathological types. Cholangiocarcinomas in large- and middle-sized intrahepatic bile ducts are mostly mucinous, while in small sized bile duct are not; mucinous extrahepatic cholangiocarcinomas are also more common than mucinous intrahepatic cholangiocarcinoma. However, it is unclear whether these pathological type differences are related to the prognosis.
Methods
Data of total 22509 patients was analyzed from Surveillance, Epidemiology, and End Results program database out of which 22299 patients were diagnosed with common adeno cholangiocarcinoma while 210 were diagnosed with mucinous cholangiocarcinoma. Based on the propensity score matching (PSM) analysis, between these two groups’ clinical, demographic, and therapeutic features were contrasted. The data were analyzed using Cox and LASSO regression analysis and Kaplan-Meier survival curves. Ultimately, overall survival (OS) and cancer specific survival (CSS) related prognostic models were established and validated in test and external datasets and nomograms were created to forecast these patients’ prognosis.
Results
There was no difference in prognosis between mucinous cholangiocarcinoma and adeno cholangiocarcinoma. Therefore, we constructed prognostic model and nomogram that can be used for mucinous and adeno cholangiocarcinoma at the same time. By comparing the 9 independent key characteristics i.e. Age, tumor size, the number of primary tumors, AJCC stage, Grade, lymph node status, metastasis, surgery and chemotherapy, risk scores were calculated for each individual. By integrating these two pathological types in OS and CSS prognostic models, effective prognosis prediction results could be achieved in multiple datasets (OS: AUC 0.70–0.87; CSS: AUC 0.74–0.89).
Conclusion
Age, tumor size, the number of primary tumors, AJCC stage, Grade, lymph node status, metastasis, surgery and chemotherapy are the independent prognostic factors in OS or CSS of the patients with mucinous and ordinary cholangiocarcinoma. Nomogram that can be used for mucinous and adeno cholangiocarcinoma at the same time is of significance in clinical practice and management of cholangiocarcinoma.
... Perihilar cholangiocarcinoma (PHC), a type of extrahepatic bile duct cancer, forms in the region where the left and right hepatic ducts join and is also called hilar cholangiocarcinoma or "Klatskin tumor". It is less common in Europe & North America [1] potentially contributing to lack of familiarity with management. PHC is rarely diagnosed "incidentally" on imaging, and typically presents with clinical manifestations related to bile duct obstruction [2]. ...
Background
To assess the outcome of previously untreated patients with perihilar cholangiocarcinoma who present to a cancer referral center with or without pre-existing trans-papillary biliary drainage.
Methods
Consecutive patients with a diagnosis of perihilar cholangiocarcinoma presenting between January 1, 2013, and December 31, 2017, were identified from a prospective surgical database and by a query of the institutional database. Of 237 patients identified, 106 met inclusion criteria and were reviewed. Clinical information was obtained from the Electronic Medical Record and imaging studies were reviewed in the Picture Archiving and Communication System.
Results
73 of 106 patients (69%) presenting with a new diagnosis of perihilar cholangiocarcinoma underwent trans-papillary biliary drainage (65 endoscopic and 8 percutaneous) prior to presentation at our institution. 8 of the 73 patients with trans-papillary biliary drainage (11%) presented with and 5 developed cholangitis; all 13 (18%) required subsequent intervention; none of the patients without trans-papillary biliary drainage presented with or required drainage for cholangitis (p = 0.008). Requiring drainage for cholangitis was more likely to delay treatment (p = 0.012) and portended a poorer median overall survival (13.6 months, 95%CI [4.08, not reached)] vs. 20.6 months, 95%CI [18.34, 37.51] p = 0.043).
Conclusion
Trans-papillary biliary drainage for perihilar cholangiocarcinoma carries a risk of cholangitis and should be avoided when possible. Clinical and imaging findings of perihilar cholangiocarcinoma should prompt evaluation at a cancer referral center before any intervention. This would mitigate development of cholangitis necessitating additional drainage procedures, delaying treatment and potentially compromising survival.
... However, severe, prolonged infections are usually associated with various hepato-biliary diseases like cholecystitis, pyogenic cholangitis, obstructive jaundice, etc. The results of experimental and epidemiological observations are in good agreement with the role of infection in the etiology of one cancer sub-type, cholangiocarcinoma, or cancer of the bile ducts [42]. ...
Currently, more than 500,000 cases of various helminthes in humans are reported annually in the Russian Federation. This figure may not reflect the true incidence of helminthes, as only nine separate nosological forms are compulsory notifiable. The rest of the species of detected helminthes are included in a separate category of “other helminthes” or “rare helminthes”. The bulk of the latter is represented by the helminthes with a rate of incidence that does not exceed one case per 100,000 people. This review is based on data derived from publications in the Russian language, both from the Russian Federation and international, as well as data available from various health treatment facilities in Russia. These data largely cover the period of the 1990s–2010s. A total of 15 species of “rare helminthes” are described in this review: anisakiosis, capillariosis, clonorchosis, dioctophymosis, dipylidiosis, echinochasmosis, fasciolosis, gastrodiscoidosis (amphistomiosis), metagonimosis, metorchiosis, nanophyetosis, pseudamphistomosis, sparganosis (spirometrosis), strongyloidosis and trichostrongylosis. Details of their geographical distribution, clinical and epidemiological peculiarities, and the difficulties they pose in diagnosis are provided. The public health importance of “rare helminthes” in Russia at present and in the forthcoming years is stressed.
... BTC refers to a heterogeneous group of GI adenocarcinomas in the liver, gallbladder, and bile ducts� There are 4 subtypes of BTC: IHCC, which occurs in the small bile ducts in the periphery of the liver; EHCC, which occurs in the main ducts of the hilum or distal region of the bile duct; GBC; and AoV� [1][2][3] Although BTCs comprise less than 1% of all cancers, they account for 10% to 15% of primary liver cancers, 4,5 which are the fifth most common cancers worldwide, 28,29 and the 12th and 18th most common cancers in males and females in Canada, respectively, in 2021� 6 The other 85% to 90% of primary liver cancers are hepatocellular carcinomas� 28,29 The most common subtype of BTC is GBC� 7,8 IHCC makes up approximately 10% to 20% of BTC cases, whereas EHCC makes up 30% to 40% of BTC cases� 5,9 The incidence of BTC varies globally, depending on various risk factors, 4 with an incidence of cholangiocarcinoma and GBC of 0�3 to 3�5 per 100,000 and 1�6 to 2�0 per 100,000, respectively, 2,5 in Europe, the US, and Australasia, although incidence rates are said to be increasing� 1,10 Rates of BTC tend to be higher in Asian cultures, with China, Thailand, South Korea, Japan, and Taiwan having some of the highest rates of incidence and mortality; 30 the highest incidence, of 90 per 100,000, is seen in Northeast Thailand� 31 Although there are few estimates of BTC in Canada, 1 study estimated the average national incidence rate of GBC and extrahepatic BTC at 30�92 cases per 1,000,000 individuals per year (approximately 3 per 100,000), 11 which increased between 1994 and 2012� 12 It has been estimated that there are approximately 400 and 5,000 new cases of cholangiocarcinoma diagnosed each year in Canada and the US,, respectively, 4,13 although these numbers are nearly 20 years old and may not reflect current incidence rates. ...
CADTH reimbursement reviews are comprehensive assessments of the clinical effectiveness and cost-effectiveness, as well as patient and clinician perspectives, of a drug or drug class. The assessments inform non-binding recommendations that help guide the reimbursement decisions of Canada's federal, provincial, and territorial governments, with the exception of Quebec. This review assesses durvalumab (50 mg/mL) concentrate for solution for IV infusion, 1,500 mg in combination with chemotherapy every 3 weeks (q.3.w.), followed by 1,500 mg every 4 weeks (q.4.w.) as monotherapy until disease progression or unacceptable toxicity. Indication: In combination with gemcitabine-based chemotherapy, for the treatment of patients with locally advanced or metastatic biliary tract cancer (BTC).
... Cox regression analysis suggested that the score could be an independent predictor for the survival of iCCA patients. The odds of advanced tumor stage in high score iCCA patients (2)(3)(4), respectively. This scoring system allowed further stratification of death rates per 100 person-years of iCCA patients. ...
Background/aim:
Prognosis of cholangiocarcinoma (CCA), especially of intrahepatic CCA (iCCA), is poor primarily due to difficulties in earlier diagnosis. Since the majority of iCCA patients are elders, their prognosis cannot be correctly predicted by pathological features and/or resection status alone. Consideration for comorbidity and/or risks of subclinical diseases at diagnosis is critically necessary for the prediction of prognosis of iCCA patients. This study aimed to develop a simple but reliable scoring system for prognosis of iCCA patients at the time of diagnosis.
Patients and methods:
Serum samples from 152 iCCA patients were collected, and four commonly used biochemical markers, serum aspartate aminotransferase, alkaline phosphatase, cystatin C and creatinine-based estimated glomerular filtration rate were measured. Then, the values of individual patients were scored as 0, 1, and 2 (low, medium, and high) by tertiles or clinically relevant cut-off points and summed to construct a prognostic score with a range between 0 to 8.
Results:
Patients with high scores of 2-4 and 5-8 exhibited significantly shorter survival times compared to those with low scores of 0-1 (Chi-square: 15.75, p<0.001). Cox regression analysis suggested that the score could be an independent predictor for the survival of iCCA patients. The odds of advanced tumor stage in high score iCCA patients (2-4 and 5-8) were 12.310 (95%CI=2.241-67.605) and 23.964 (95%CI=3.296-174.216), respectively. This scoring system allowed further stratification of death rates per 100 person-years of iCCA patients.
Conclusion:
The ability of such a simple scoring system to discriminate risk might be helpful for iCCA patients to determine therapeutic programs at the time of diagnosis.
... Previous reports suggest that the incidence of ICC was 1-2 per 100,000 individuals. Our recent analysis is consistent with this report with an incidence ranging between 1 and 0.8 per 100,000 for male and female, respectively [15]. This incidence is reportedly higher in the Asian population, up to 10 per 100,000 persons [15]. ...
... Our recent analysis is consistent with this report with an incidence ranging between 1 and 0.8 per 100,000 for male and female, respectively [15]. This incidence is reportedly higher in the Asian population, up to 10 per 100,000 persons [15]. ...
Backgrounds/aims: Historically, the incidence and prognosis of patients diagnosed with intrahepatic cholangiocarcinoma (ICC) have been inadequately understood. Survival analysis in ICC has yet to be investigated in a population-based study.
Methods: We conducted a retrospective cohort study using the Surveillance, Epidemiology, and End Results Program (SEER) 18 Registry. Risk ratios were estimated via Poisson regression. Hazard ratios for 5-year survival were estimated using hierarchical Cox regression models.
Results: Males show a higher rate of age-adjusted ICC incidence. Blacks carried a decreased risk of ICC diagnosis than Whites, while Asians revealed a higher risk of ICC diagnosis when compared with Whites. The observed survival rates at 12, 36, and 60 months were 36.3%, 12.8%, and 8.1%, respectively. Compared with Whites, Blacks showed an increased risk of death (p < 0.01). Lymph node resection during surgery was associated with a 64.1% reduced risk of mortality (p < 0.01). A higher T stage at diagnosis was associated with poor survival (p < 0.01). Surgery combined with chemoradiotherapy, radiotherapy, or chemotherapy was associated with a reduced risk of mortality compared with nonsurgical interventions (p < 0.01).
Conclusions: ICC incidence has been increasing since 2000, especially in White males. The risk of ICC rises with age. Lymph node removal is associated with better survival. In recent years, survival had worsened, and surgical intervention improved survival compared with nonsurgical management.
... Khon Kaen province in Thailand and Qidong in China). [33][34][35] These areas have certain traditional eating practices, where people consume raw/fermented fish. The uncooked/fermented fish contain encysted metacercaria, which causes infection in humans. ...
Parasitic diseases continue to affect millions of people in the endemic areas causing morbidity as well as affecting the quality of life. The visitors to these endemic areas get infected with these parasites and present a confusing picture to the physicians in their native area. Prolonged exposure to some of these parasites like is a well-known risk factor for malignancy. However, most of these diseases are easily curable. This review article provides a brief description of a few parasitoses like amebiasis, ascariasis, clonorchiasis, opisthorchiasis, and fascioliasis. Their causative agents, disease-causing mechanisms in the host, clinical features, specific radiologic findings, and immunodiagnostic tests are discussed. The medical and surgical aspects of treating these parasitoses are also summarized.
... Conclusion: Differences were identified in oncological outcomes between PHC and DBC, including pathologic findings and survival outcomes. Key Words: Bile duct neoplasms, Cholangiocarcinoma, Klatskin tumor, Pathology, Survival analysis incidence rate for EHC was found in Korea [8]. ...
Purpose:
Extrahepatic cholangiocarcinoma is distinguished into perihilar cholangiocarcinoma (PHC) and distal bile duct cancer (DBC). The studies for each subtype have been conducted separately. This study compared oncological outcomes between PHC and DBC.
Methods:
From 2001 to 2017, patients who underwent surgery at Seoul National University Hospital for PHC or DBC were enrolled. T stage was reclassified for tumor extent as 'confined to' or 'beyond' the bile duct (BD). In survival analysis, stage matching was performed based on tumor extent and lymph node (LN) metastasis.
Results:
There were 680 patients enrolled: 295 with PHC and 385 with DBC. The R0 resection rate was higher in DBC (77.3% vs. 89.9%, P = 0.001). Tumors confined to BD were more common in PHC (61.7% vs. 37.7%, P = 0.001). The 5-year survival rate (5YSR) was higher in DBC patients (30.8% vs. 47.8%, P = 0.001). After stage matching, DBC patients showed better 5YSR for tumors confined to BD/LN(-) (47.1% vs. 64.3%), confined to BD/LN(+) (22.0% vs. 35.0%), beyond BD/LN(-) (21.9% vs. 49.8%), and beyond BD/LN(+) (9.6% vs. 26.9%). The overall recurrence rate was higher in PHC (59.7% vs. 51.9%, P = 0.045), with no difference in the recurrence types between two groups. Radiation therapy was effective for patients with advanced stage disease (5YSR: 35.8% vs. 29.5%, P = 0.022); adjuvant chemotherapy was effective for patients receiving R1 resection (5YSR: 37.3% vs. 13.2%, P = 0.040).
Conclusion:
Differences were identified in oncological outcomes between PHC and DBC, including pathologic findings and survival outcomes.
... In Eastern countries, the incidence is higher than in Western ones, where it is estimated to be lower than 4 cases/100,000 people/year [2]. Northeast Thailand has the highest CCA rate in the world (90 cases/100,000 people/year) [3]. The highest incidence rate is in the seventh decade, with a slight prevalence in males. ...
Cholangiocarcinoma is a group of malignancies with poor prognosis. Treatments for the management of advanced-stage cholangiocarcinoma are limited, and the 5-year survival rate is estimated to be approximately 5–15%, considering all tumor stages. There is a significant unmet need for effective new treatment approaches. The present review is provided with the aim of summarizing the current evidence and future perspectives concerning new therapeutic strategies for cholangiocarcinoma. The role of targeted therapies and immunotherapies is currently investigational in cholangiocarcinoma. These therapeutic options might improve survival outcomes, as shown by the promising results of several clinical trials illustrated in the present review. The co-presence of driver mutations and markers of susceptibility to immunotherapy may lead to rational combination strategies and clinical trial development. A better understanding of immunologically based therapeutic weapons is needed, which will lead to a form of a precision medicine strategy capable of alleviating the clinical aggressiveness and to improve the prognosis of cholangiocarcinoma.
... Intrahepatic cholangiocarcinomas have distinct clinical course and epidemiology from perihilar and extrahepatic cholangiocarcinomas [1]. It usually occurs between fifth and seventh decades [2] and affects both men and women equally [3]. Ultrasound-guided needle biopsy is gold standard for diagnosis. ...
