Temporal trends in liver-directed therapy of patients with intrahepatic cholangiocarcinoma in the United States: A population-based analysis

• Published in: Journal of surgical oncology 2014-08, Vol.110 (2), p.163-170
• Main Authors: Amini, Neda, Ejaz, Aslam, Spolverato, Gaya, Kim, Yuhree, Herman, Joseph M., Pawlik, Timothy M.
• Format: Article
• Language: English
• Subjects: Ablation Techniques - statistics & numerical data; Ablation Techniques - trends; Ablation Techniques - utilization; Adult; Aged; Aged, 80 and over; Bile Duct Neoplasms; Bile Ducts, Intrahepatic; cholangiocarcinoma; Cholangiocarcinoma - mortality; Cholangiocarcinoma - therapy; Female; Hepatectomy - statistics & numerical data; Hepatectomy - trends; Hepatectomy - utilization; Humans; intrahepatic; Liver Neoplasms - mortality; Liver Neoplasms - therapy; liver-directed; Logistic Models; Male; Middle Aged; Multivariate Analysis; outcome; population-based; Radiotherapy - statistics & numerical data; Radiotherapy - trends; Radiotherapy - utilization; Retrospective Studies; SEER Program; Survival Rate; Treatment Outcome; United States
• ISSN: 0022-4790; 1096-9098
• DOI: 10.1002/jso.23605

Background and Objectives Data on outcomes after liver‐directed therapy for intrahepatic cholangiocarcinoma (ICC) are limited due to the rarity of the disease. We sought to define overall utilization and temporal trends of liver‐directed therapy for ICC. Methods We identified 5,388 patients with ICC using the Surveillance Epidemiology and End Results (SEER) database between 1983 and 2010. Patients were characterized based on the type of liver‐directed therapy received: surgical resection, ablation therapy, and radiation therapy. Results The majority of patients did not undergo liver‐directed therapy (n = 4,156, 77.1%). Among those undergoing liver‐directed therapy, surgical resection was most commonly performed (n = 672, 54.5%) and its utilization increased threefold over time (P = 0.001). The use of ablation therapy alone was used in 5.2% of patients and increased nearly sixfold over time (P = 0.39) whereas the use of radiation therapy alone decreased by nearly half (P 5 cm). Conclusion There was a moderate improvement in overall survival in patients with ICC between 1983 and 2010. The majority of patients with ICC are not undergoing liver‐directed therapy. Among those who do undergo liver‐directed therapy, the use of ablation therapy and surgery are increasing with nearly three in five patients undergoing resection. J. Surg. Oncol. 2014; 110:163–170. © 2014 Wiley Periodicals, Inc.