Faculty of Medicine, Cairo University, Cairo, Egypt.
Division of Gastroenterology, Baylor College of Medicine, Houston, Texas.
Cancer Epidemiol Biomarkers Prev. 2022 Dec 5;31(12):2169-2176. doi: 10.1158/1055-9965.EPI-22-0444.
Intrahepatic cholangiocarcinoma (iCCA) has shown a substantial increase in mortality globally. On the contrary, perihilar cholangiocarcinoma and distal cholangiocarcinoma have been decreasing. We aim to evaluate the causes of death after iCCA diagnosis.
We studied 8,962 patients with iCCA diagnosed between 2000 and 2018 in the United States. The standardized mortality ratio for each cause of death was calculated. We used R software version 3.5 to perform Kaplan-Meier survival tests and covariate-adjusted Cox models.
Of the 8,962 patients diagnosed with iCCA, 7,335 (81.8%) died during the follow-up period with a mean age of death of 67.88 years. The highest number of deaths (4,786; 65.2%) occurred within the first year following iCCA diagnosis. 4,832 (66%) were from iCCA, 2,063 (28%) were from other cancers, and 440 (6%) were from non-cancer causes mainly cardiovascular disease. The overall mean survival after 1 year of diagnosis was 40.8% (39.8-41.9); however, the overall mean survival was 9.8% (9-10.5) after 5 years of diagnosis. The multivariable analysis showed that age, sex, stage, and management of iCCA have a statistically significant impact on survival.
Following iCCA diagnosis, about 34% died from non-iCCA causes. The most common non-iCCA cancer cause was liver cancer, and cardiovascular disease represents a substantial percentage of non-cancer deaths. Our findings provide insights into how iCCA survivors should be followed up regarding future risks.
The management and follow-up should be tailored to the needs of each patient with iCCA.
全球范围内肝内胆管癌（iCCA）的死亡率显著上升。相反，肝门部胆管癌和远端胆管癌的死亡率一直在下降。我们旨在评估 iCCA 诊断后的死亡原因。
我们研究了 2000 年至 2018 年期间在美国诊断为 iCCA 的 8962 名患者。计算了每种死因的标准化死亡率比值。我们使用 R 软件版本 3.5 进行 Kaplan-Meier 生存分析和协变量调整的 Cox 模型。
在诊断为 iCCA 的 8962 名患者中，7335 名（81.8%）在随访期间死亡，死亡时的平均年龄为 67.88 岁。在 iCCA 诊断后的第一年，死亡人数最多（4786 人；65.2%）。4832 人（66%）死于 iCCA，2063 人（28%）死于其他癌症，440 人（6%）死于非癌症原因，主要为心血管疾病。诊断后 1 年的总体平均生存率为 40.8%（39.8-41.9）；然而，诊断后 5 年的总体平均生存率为 9.8%（9-10.5）。多变量分析表明，年龄、性别、分期和 iCCA 的治疗对生存有统计学意义的影响。
在 iCCA 诊断后，约 34%的患者死于非 iCCA 原因。最常见的非 iCCA 癌症原因是肝癌，心血管疾病代表了相当一部分非癌症死亡。我们的研究结果提供了关于 iCCA 幸存者未来风险应如何进行随访的见解。
iCCA 的管理和随访应根据每个患者的需求进行定制。
