Nationwide treatment and outcomes of perihilar cholangiocarcinoma

Anne-Marleen van Keulen; Stijn Franssen; Lydia G. van der Geest; Marieke T. de Boer; Minneke Coenraad; Lydi M. J. W. van Driel; Joris I. Erdmann; Nadia Haj Mohammad; Lara Heij; Heinz-Josef Klumpen; Eric Tjwa; Liselot Valkenburg-van Iersel; Joanne Verheij; Bas Groot Koerkamp; Pim B. Olthof; Dutch Hepatocellular & Cholangiocarcinoma Group (DHCG)

doi:10.1111/liv.14856

Nationwide treatment and outcomes of perihilar cholangiocarcinoma

Anne-Marleen van Keulen, Stijn Franssen, Lydia G. van der Geest, Marieke T. de Boer, Minneke Coenraad, Lydi M. J. W. van Driel, Joris I. Erdmann, Nadia Haj Mohammad, Lara Heij, Heinz-Josef Klumpen, Eric Tjwa, Liselot Valkenburg-van Iersel, Joanne Verheij, Bas Groot Koerkamp, Pim B. Olthof^*, Dutch Hepatocellular & Cholangiocarcinoma Group (DHCG)

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Background Perihilar cholangiocarcinoma (pCCA) is a rare tumour that requires complex multidisciplinary management. All known data are almost exclusively derived from expert centres. This study aimed to analyse the outcomes of patients with pCCA in a nationwide cohort.

Methods Data on all patients diagnosed with pCCA in the Netherlands between 2010 and 2018 were obtained from the Netherlands Cancer Registry. Data included type of hospital of diagnosis and the received treatment. Outcomes included the type of treatment and overall survival.

Results A total of 2031 patients were included and the median overall survival for the overall cohort was 5.2 (95% CI 4.7-5.7) months. Three-hundred-ten (15%) patients underwent surgical resection, 271 (13%) underwent palliative systemic treatment, 21 (1%) palliative local anti-cancer treatment and 1429 (70%) underwent best supportive care. These treatments resulted in a median overall survival of 29.6 (95% CI 25.2-34.0), 12.2 (95% CI 11.0-13.3), 14.5 (95%CI 8.2-20.8) and 2.9 (95% CI 2.6-3.2) months respectively. Resection rate was 13% in patients who were diagnosed in non-academic and 32% in academic centres (P ), which resulted in a survival difference in favour of academic centres. Median overall survival was 9.7 (95% CI 7.7-11.7) months in academic centres compared to 4.9 (95% CI 4.3-5.4) months in non-academic centres (P ).

Conclusions In patients with pCCA, resection rate and overall survival were higher for patients who were diagnosed in academic centres. These results show population-based outcomes of pCCA and highlight the importance of regional collaboration in the treatment of these patients.

Original language	English
Pages (from-to)	1945-1953
Number of pages	9
Journal	Liver International
Volume	41
Issue number	8
DOIs	https://doi.org/10.1111/liv.14856
Publication status	Published - Aug 2021

Keywords

cholangiocarcinoma
klatskin tumour
treatment outcome
HILAR CHOLANGIOCARCINOMA
STAGING SYSTEM
CANCER
CHEMOTHERAPY
GEMCITABINE
GUIDELINES
DIAGNOSIS
CISPLATIN
SURVIVAL
TRIAL

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10.1111/liv.14856Licence: CC BY-NC

Cite this

van Keulen, A.-M., Franssen, S., van der Geest, L. G., de Boer, M. T., Coenraad, M., van Driel, L. M. J. W., Erdmann, J. I., Haj Mohammad, N., Heij, L., Klumpen, H.-J., Tjwa, E., Valkenburg-van Iersel, L., Verheij, J., Groot Koerkamp, B., Olthof, P. B., & Dutch Hepatocellular & Cholangiocarcinoma Group (DHCG) (2021). Nationwide treatment and outcomes of perihilar cholangiocarcinoma. Liver International, 41(8), 1945-1953. https://doi.org/10.1111/liv.14856

@article{8b2d83b2d1b84636b5d166e9ec5f7a9c,

title = "Nationwide treatment and outcomes of perihilar cholangiocarcinoma",

abstract = "Background Perihilar cholangiocarcinoma (pCCA) is a rare tumour that requires complex multidisciplinary management. All known data are almost exclusively derived from expert centres. This study aimed to analyse the outcomes of patients with pCCA in a nationwide cohort.Methods Data on all patients diagnosed with pCCA in the Netherlands between 2010 and 2018 were obtained from the Netherlands Cancer Registry. Data included type of hospital of diagnosis and the received treatment. Outcomes included the type of treatment and overall survival.Results A total of 2031 patients were included and the median overall survival for the overall cohort was 5.2 (95% CI 4.7-5.7) months. Three-hundred-ten (15%) patients underwent surgical resection, 271 (13%) underwent palliative systemic treatment, 21 (1%) palliative local anti-cancer treatment and 1429 (70%) underwent best supportive care. These treatments resulted in a median overall survival of 29.6 (95% CI 25.2-34.0), 12.2 (95% CI 11.0-13.3), 14.5 (95%CI 8.2-20.8) and 2.9 (95% CI 2.6-3.2) months respectively. Resection rate was 13% in patients who were diagnosed in non-academic and 32% in academic centres (P ), which resulted in a survival difference in favour of academic centres. Median overall survival was 9.7 (95% CI 7.7-11.7) months in academic centres compared to 4.9 (95% CI 4.3-5.4) months in non-academic centres (P ).Conclusions In patients with pCCA, resection rate and overall survival were higher for patients who were diagnosed in academic centres. These results show population-based outcomes of pCCA and highlight the importance of regional collaboration in the treatment of these patients.",

keywords = "cholangiocarcinoma, klatskin tumour, treatment outcome, HILAR CHOLANGIOCARCINOMA, STAGING SYSTEM, CANCER, CHEMOTHERAPY, GEMCITABINE, GUIDELINES, DIAGNOSIS, CISPLATIN, SURVIVAL, TRIAL",

author = "{van Keulen}, Anne-Marleen and Stijn Franssen and {van der Geest}, {Lydia G.} and {de Boer}, {Marieke T.} and Minneke Coenraad and {van Driel}, {Lydi M. J. W.} and Erdmann, {Joris I.} and {Haj Mohammad}, Nadia and Lara Heij and Heinz-Josef Klumpen and Eric Tjwa and {Valkenburg-van Iersel}, Liselot and Joanne Verheij and {Groot Koerkamp}, Bas and Olthof, {Pim B.} and {Dutch Hepatocellular & Cholangiocarcinoma Group (DHCG)}",

note = "Funding Information: The authors report no acknowledgements Publisher Copyright: {\textcopyright} 2021 The Authors. Liver International published by John Wiley & Sons Ltd",

year = "2021",

month = aug,

doi = "10.1111/liv.14856",

language = "English",

volume = "41",

pages = "1945--1953",

journal = "Liver International",

issn = "1478-3223",

publisher = "Wiley",

number = "8",

}

van Keulen, A-M, Franssen, S, van der Geest, LG, de Boer, MT, Coenraad, M, van Driel, LMJW, Erdmann, JI, Haj Mohammad, N, Heij, L, Klumpen, H-J, Tjwa, E, Valkenburg-van Iersel, L, Verheij, J, Groot Koerkamp, B, Olthof, PB & Dutch Hepatocellular & Cholangiocarcinoma Group (DHCG) 2021, 'Nationwide treatment and outcomes of perihilar cholangiocarcinoma', Liver International, vol. 41, no. 8, pp. 1945-1953. https://doi.org/10.1111/liv.14856

TY - JOUR

T1 - Nationwide treatment and outcomes of perihilar cholangiocarcinoma

AU - van Keulen, Anne-Marleen

AU - Franssen, Stijn

AU - van der Geest, Lydia G.

AU - de Boer, Marieke T.

AU - Coenraad, Minneke

AU - van Driel, Lydi M. J. W.

AU - Erdmann, Joris I.

AU - Haj Mohammad, Nadia

AU - Heij, Lara

AU - Klumpen, Heinz-Josef

AU - Tjwa, Eric

AU - Valkenburg-van Iersel, Liselot

AU - Verheij, Joanne

AU - Groot Koerkamp, Bas

AU - Olthof, Pim B.

AU - Dutch Hepatocellular & Cholangiocarcinoma Group (DHCG)

PY - 2021/8

Y1 - 2021/8

N2 - Background Perihilar cholangiocarcinoma (pCCA) is a rare tumour that requires complex multidisciplinary management. All known data are almost exclusively derived from expert centres. This study aimed to analyse the outcomes of patients with pCCA in a nationwide cohort.Methods Data on all patients diagnosed with pCCA in the Netherlands between 2010 and 2018 were obtained from the Netherlands Cancer Registry. Data included type of hospital of diagnosis and the received treatment. Outcomes included the type of treatment and overall survival.Results A total of 2031 patients were included and the median overall survival for the overall cohort was 5.2 (95% CI 4.7-5.7) months. Three-hundred-ten (15%) patients underwent surgical resection, 271 (13%) underwent palliative systemic treatment, 21 (1%) palliative local anti-cancer treatment and 1429 (70%) underwent best supportive care. These treatments resulted in a median overall survival of 29.6 (95% CI 25.2-34.0), 12.2 (95% CI 11.0-13.3), 14.5 (95%CI 8.2-20.8) and 2.9 (95% CI 2.6-3.2) months respectively. Resection rate was 13% in patients who were diagnosed in non-academic and 32% in academic centres (P ), which resulted in a survival difference in favour of academic centres. Median overall survival was 9.7 (95% CI 7.7-11.7) months in academic centres compared to 4.9 (95% CI 4.3-5.4) months in non-academic centres (P ).Conclusions In patients with pCCA, resection rate and overall survival were higher for patients who were diagnosed in academic centres. These results show population-based outcomes of pCCA and highlight the importance of regional collaboration in the treatment of these patients.

AB - Background Perihilar cholangiocarcinoma (pCCA) is a rare tumour that requires complex multidisciplinary management. All known data are almost exclusively derived from expert centres. This study aimed to analyse the outcomes of patients with pCCA in a nationwide cohort.Methods Data on all patients diagnosed with pCCA in the Netherlands between 2010 and 2018 were obtained from the Netherlands Cancer Registry. Data included type of hospital of diagnosis and the received treatment. Outcomes included the type of treatment and overall survival.Results A total of 2031 patients were included and the median overall survival for the overall cohort was 5.2 (95% CI 4.7-5.7) months. Three-hundred-ten (15%) patients underwent surgical resection, 271 (13%) underwent palliative systemic treatment, 21 (1%) palliative local anti-cancer treatment and 1429 (70%) underwent best supportive care. These treatments resulted in a median overall survival of 29.6 (95% CI 25.2-34.0), 12.2 (95% CI 11.0-13.3), 14.5 (95%CI 8.2-20.8) and 2.9 (95% CI 2.6-3.2) months respectively. Resection rate was 13% in patients who were diagnosed in non-academic and 32% in academic centres (P ), which resulted in a survival difference in favour of academic centres. Median overall survival was 9.7 (95% CI 7.7-11.7) months in academic centres compared to 4.9 (95% CI 4.3-5.4) months in non-academic centres (P ).Conclusions In patients with pCCA, resection rate and overall survival were higher for patients who were diagnosed in academic centres. These results show population-based outcomes of pCCA and highlight the importance of regional collaboration in the treatment of these patients.

KW - cholangiocarcinoma

KW - klatskin tumour

KW - treatment outcome

KW - HILAR CHOLANGIOCARCINOMA

KW - STAGING SYSTEM

KW - CANCER

KW - CHEMOTHERAPY

KW - GEMCITABINE

KW - GUIDELINES

KW - DIAGNOSIS

KW - CISPLATIN

KW - SURVIVAL

KW - TRIAL

U2 - 10.1111/liv.14856

DO - 10.1111/liv.14856

M3 - Article

C2 - 33641214

SN - 1478-3223

VL - 41

SP - 1945

EP - 1953

JO - Liver International

JF - Liver International

IS - 8

ER -