Temporal Trends in Liver-Directed Therapy of Patients With Intrahepatic Cholangiocarcinoma in the United States: A Population-Based Analysis
Temporal Trends in Liver-Directed Therapy of Patients With Intrahepatic Cholangiocarcinoma in the United States: A Population-Based Analysis
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DOI：
10.1002/jso.23605
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发表时间：
2014-08-01
影响因子：
2.5
通讯作者：
Pawlik, Timothy M.
中科院分区：
文献类型：
--
作者：
Amini, Neda;Ejaz, Aslam;Pawlik, Timothy M.
背景和目的：由于肝内胆管癌（ICC）的罕见性，有关肝内胆管癌（ICC）肝脏定向治疗后结果的数据有限。我们试图定义 ICC 肝脏定向治疗的总体利用率和时间趋势。方法：我们使用 1983 年至 2010 年间的监测流行病学和最终结果 (SEER) 数据库识别了 5,388 名 ICC 患者。根据接受的肝脏定向治疗类型对患者进行特征分析：手术切除、消融治疗和放射治疗。结果：大多数患者没有接受肝脏定向治疗（n = 4,156, 77.1%）。在接受肝脏定向治疗的患者中，手术切除最为常见（n = 672，54.5%），并且其利用率随着时间的推移增加了三倍（P = 0.001）。 5.2% 的患者单独使用消融疗法，并且随着时间的推移增加了近六倍 (P = 0.39)，而单独使用放射疗法的患者则减少了近一半 (P < 0.001)。总体中位生存期为 10 个月。生存的不良预测因素包括基于肿瘤的因素，例如区域和远处疾病，以及低分化和大肿瘤（> 5 cm）。结论：1983年至2010年间，ICC患者的总生存率有适度改善。大多数ICC患者没有接受肝脏定向治疗。在接受肝脏定向治疗的患者中，消融疗法和手术的使用正在增加，近五分之三的患者接受了切除术。 (C) 2014 年 Wiley 期刊公司。
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 < 0.001). Overall median survival was 10 months. Poor predictors of survival include tumor-based factors such as regional and distant disease, as well as poorly differentiated and large tumors (>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. (C) 2014 Wiley Periodicals, Inc.