Olthof Pim B, Franssen Stijn, van Keulen Anne-Marleen, van der Geest Lydia G, Hoogwater Frederik J H, Coenraad Minneke, van Driel Lydi M J W, Erdmann Joris I, Mohammad Nadia H, Heij Lara, Klümpen Heinz-Josef, Tjwa Eric, Valkenburg-van Iersel Liselot, Verheij Joanne, Groot Koerkamp Bas
Department of Surgery, Erasmus MC Cancer Institute, Rotterdam, the Netherlands; Department of Surgery, University Medical Center Groningen, Groningen, the Netherlands.
Department of Surgery, Erasmus MC Cancer Institute, Rotterdam, the Netherlands.
HPB (Oxford). 2023 Nov;25(11):1329-1336. doi: 10.1016/j.hpb.2023.06.019. Epub 2023 Jul 17.
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.
Data on all patients diagnosed with iCCA between 2010 and 2018 were obtained from the Netherlands Cancer Registry.
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).
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.
大多数关于肝内胆管癌（iCCA）治疗及预后的数据来自专家中心。本研究旨在调查全国队列中所有诊断为iCCA患者的治疗情况及预后。
从荷兰癌症登记处获取2010年至2018年间所有诊断为iCCA患者的数据。
共纳入1747例诊断为iCCA的患者。292例患者（17%）接受了手术切除，548例患者（31%）接受了姑息性全身治疗，867例患者（50%）接受了最佳支持治疗（BSC）。手术切除后的中位总生存期（OS）以及1年和3年总生存率分别为：37.5个月（31.0 - 44.0）、79.2%和51.6%；接受全身治疗的分别为10.0个月（9.2 - 10.8）、38.4%和5.1%；接受最佳支持治疗的分别为2.2个月（2.0 - 2.5）、10.4%和1.3%。首次就诊于学术中心的患者手术切除率为33%（96/292），而非学术中心为13%（195/1454）（P < 0.001）。
在8年期间，近1750例iCCA患者中有一半未接受任何治疗，1年总生存率为10.4%。手术切除后3年生存率约为50%，而姑息治疗后长期生存罕见。学术中心的手术切除率高于非学术中心。
