Jeri-Yabar Antoine, Vittini-Hernandez Liliana, Salazar-Linares Brenda, Prado-Nunez Sebastian
Department of Medicine, Icahn School of Medicine at Mount Sinai Morningside/West, New York, USA.
Department of Medicine, Lincoln Hospital, New York, USA.
Asian Pac J Cancer Prev. 2025 May 1;26(5):1823-1830. doi: 10.31557/APJCP.2025.26.5.1823.
The incidence of young-onset cholangiocarcinoma (YOCC) is rising, yet the survival outcomes and metastatic patterns of metastatic YOCC (mYOCC) compared to metastatic average-onset cholangiocarcinoma (mAOCC) remain unclear. This study evaluates differences in survival outcomes, metastatic patterns, and associated prognostic factors between mYOCC and mAOCC.
A retrospective cohort study was conducted using the SEER database (2018-2021), including patients aged ≥18 years with metastatic cholangiocarcinoma (mCC). Patients were stratified into mYOCC (<50 years) and mAOCC (≥50 years). Clinical characteristics, metastatic sites, and treatment modalities were analyzed. Kaplan-Meier and Cox proportional hazards models were used to assess overall survival (OS) and cancer-specific survival (CSS).
Of 1,601 patients with mCC, 9.99% had mYOCC. mYOCC patients were younger (median age 44 vs. 66 years, p<0.001) and more frequently presented with bone (27.50% vs. 19.36%, p=0.015) and lung metastases (36.25% vs. 27.48%, p=0.021). They also had a higher prevalence of multiple-site metastases, including bone-liver-lung combinations (7.50% vs. 3.33%, p=0.008). Median survival was 12 months for mYOCC versus 9 months for mAOCC. mYOCC patients had a lower risk of mortality (aHR=0.74, 95% CI: 0.60-0.93, p=0.01). Treatment modalities, including chemotherapy and surgery, significantly improved survival, regardless of age at diagnosis.
mYOCC demonstrates distinct metastatic patterns, including higher frequencies of bone and lung metastases, and is associated with better survival outcomes compared to mAOCC. These findings highlight the need for age-specific diagnostic and therapeutic approaches to improve outcomes for mYOCC patients. Further research is needed to understand the biological mechanisms underlying these differences and address disparities in survival outcomes.
青年起病型胆管癌（YOCC）的发病率正在上升，但与转移性平均起病型胆管癌（mAOCC）相比，转移性YOCC（mYOCC）的生存结果和转移模式仍不清楚。本研究评估了mYOCC和mAOCC在生存结果、转移模式及相关预后因素方面的差异。
利用监测、流行病学与最终结果（SEER）数据库（2018 - 2021年）进行了一项回顾性队列研究，纳入年龄≥18岁的转移性胆管癌（mCC）患者。患者被分为mYOCC（<50岁）和mAOCC（≥50岁）。分析了临床特征、转移部位和治疗方式。采用Kaplan - Meier法和Cox比例风险模型评估总生存期（OS）和癌症特异性生存期（CSS）。
在1601例mCC患者中，9.99%为mYOCC。mYOCC患者更年轻（中位年龄44岁对66岁，p<0.001），更常出现骨转移（27.50%对19.36%，p = 0.015）和肺转移（36.25%对27.48%，p = 0.021）。他们多部位转移的发生率也更高，包括骨 - 肝 - 肺联合转移（7.50%对3.33%，p = 0.008）。mYOCC的中位生存期为12个月，而mAOCC为9个月。mYOCC患者的死亡风险较低（风险比 = 0.74，95%置信区间：0.60 - 0.93，p = 0.01）。治疗方式，包括化疗和手术，无论诊断时的年龄如何，均能显著改善生存期。
mYOCC表现出独特的转移模式，包括更高频率的骨转移和肺转移，与mAOCC相比，其生存结果更好。这些发现凸显了针对不同年龄的诊断和治疗方法对于改善mYOCC患者预后的必要性。需要进一步研究以了解这些差异背后的生物学机制，并解决生存结果方面的差异。
