Nationwide treatment and outcomes of intrahepatic cholangiocarcinoma

Pim B Olthof; Stijn Franssen; Anne-Marleen van Keulen; Lydia G van der Geest; Frederik J H Hoogwater; Minneke Coenraad; Lydi M J W van Driel; Joris I Erdmann; Nadia H Mohammad; Lara Heij; Heinz-Josef Klümpen; Eric Tjwa; Liselot Valkenburg-van Iersel; Joanne Verheij; Bas Groot Koerkamp; Dutch Hepatocellular & Cholangiocarcinoma Group (DHCG)

doi:10.1016/j.hpb.2023.06.019

Nationwide treatment and outcomes of intrahepatic cholangiocarcinoma

HPB (Oxford). 2023 Nov;25(11):1329-1336. doi: 10.1016/j.hpb.2023.06.019. Epub 2023 Jul 17.

Authors

Pim B Olthof¹, Stijn Franssen², Anne-Marleen van Keulen², Lydia G van der Geest³, Frederik J H Hoogwater⁴, Minneke Coenraad⁵, Lydi M J W van Driel⁶, Joris I Erdmann⁷, Nadia H Mohammad⁸, Lara Heij⁹, Heinz-Josef Klümpen¹⁰, Eric Tjwa¹¹, Liselot Valkenburg-van Iersel¹², Joanne Verheij¹³, Bas Groot Koerkamp²; Dutch Hepatocellular & Cholangiocarcinoma Group (DHCG)

Affiliations

¹ Department of Surgery, Erasmus MC Cancer Institute, Rotterdam, the Netherlands; Department of Surgery, University Medical Center Groningen, Groningen, the Netherlands. Electronic address: p.olthof@erasmusmc.nl.
² Department of Surgery, Erasmus MC Cancer Institute, Rotterdam, 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, 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; Visceral and Transplant Surgery, University Hospital RWTH Aachen, Aachen, Germany; NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands.
¹⁰ Department of Medical Oncology, Amsterdam UMC, Location University of Amsterdam, Amsterdam, the Netherlands.
¹¹ Department of Gastroenterology, Radboud University Medical Center, Nijmegen, the Netherlands.
¹² Department of Internal Medicine, Division of Medical Oncology, GROW-School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, the Netherlands.
¹³ Department of Pathology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands.

PMID: 37532665
DOI: 10.1016/j.hpb.2023.06.019

Abstract

Background: Most data on the treatment and outcomes of intrahepatic cholangiocarcinoma (iCCA) derives from expert centers. This study aimed to investigate the treatment and outcomes of all patients diagnosed with iCCA in a nationwide cohort.

Methods: Data on all patients diagnosed with iCCA between 2010 and 2018 were obtained from the Netherlands Cancer Registry.

Results: In total, 1747 patients diagnosed with iCCA were included. Resection was performed in 292 patients (17%), 548 patients (31%) underwent palliative systemic treatment, and 867 patients (50%) best supportive care (BSC). The OS median and 1-, and 3-year OS were after resection: 37.5 months (31.0-44.0), 79.2%, and 51.6%,; with systemic therapy, 10.0 months (9.2-10.8), 38.4%, and 5.1%, and with BSC 2.2 months (2.0-2.5), 10.4%, and 1.3% respectively. The resection rate for patients who first presented in academic centers was 33% (96/292) compared to 13% (195/1454) in non-academic centers (P < 0.001).

Discussion: Half of almost 1750 patients with iCCA over an 8 year period did not receive any treatment with a 1-year OS of 10.4%. Three-year survival was about 50% after resection, while long-term survival was rare after palliative treatment. The resection rate was higher in academic centers compared to non-academic centers.