International journal of surgery (London, England) · 2025
Cholangiocarcinoma in Denmark: time trends in mortality following resection.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
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Jensen Morten D, West Joe, Weber Britta, Markussen Alice, Mortensen Frank V, Jepsen Peter
Аннотация
BACKGROUND: Cholangiocarcinomas have a poor prognosis, and resection is the only curative-intent treatment. We examined time trends in mortality risk after resection in a nationwide Danish cohort.
METHODS: We identified all Danish citizens diagnosed with cholangiocarcinoma in 2004-2022 who subsequently underwent liver resection, biliary tract resection, or a combination of the two. We computed the proportions of patients who received downstaging or adjuvant chemotherapy, and we estimated age- and sex-adjusted mortality risks.
RESULTS: Between 2004 and 2022, 611 patients with cholangiocarcinoma underwent resection (13% of 4572 patients with cholangiocarcinoma). The proportion who underwent resection increased from 9% in 2004-2012 to 16% in 2018-2022, the median age of resected patients rose from 65 to 69 years, and the proportion with comorbidities increased from 17% to 28%. In patients who underwent liver resection, the proportion who had received downstaging chemotherapy increased from <7% in 2004-2012 to 12% (8-20), and the proportion who received adjuvant chemotherapy increased from 27% (18-39) in 2004-2012 to 49% (40-58) in 2018-2022. Despite the increasing use of chemotherapy before and after liver resection, age- and sex-adjusted mortality remained essentially the same, with 1-year mortality ranging from 14% to 20% ( P -value = 0.37). In patients who underwent biliary tract resection, only 3% received downstaging chemotherapy, but the proportion who received adjuvant therapy increased from 17% (10-29) in 2004-2012 to 59% (48-68) in 2018-2022. Even so, these patients' age- and sex-adjusted mortality remained stable (1-year mortality ranging from 19% to 24%, P -value = 0.34).
CONCLUSION: The proportion of patients with cholangiocarcinoma who underwent liver or biliary tract resection increased, and more patients received downstaging chemotherapy and adjuvant chemotherapy. Nonetheless, age- and sex-adjusted mortality risks remained constant. The explanations for this pattern are unclear but likely involve changing patient characteristics other than age and sex.
METHODS: We identified all Danish citizens diagnosed with cholangiocarcinoma in 2004-2022 who subsequently underwent liver resection, biliary tract resection, or a combination of the two. We computed the proportions of patients who received downstaging or adjuvant chemotherapy, and we estimated age- and sex-adjusted mortality risks.
RESULTS: Between 2004 and 2022, 611 patients with cholangiocarcinoma underwent resection (13% of 4572 patients with cholangiocarcinoma). The proportion who underwent resection increased from 9% in 2004-2012 to 16% in 2018-2022, the median age of resected patients rose from 65 to 69 years, and the proportion with comorbidities increased from 17% to 28%. In patients who underwent liver resection, the proportion who had received downstaging chemotherapy increased from <7% in 2004-2012 to 12% (8-20), and the proportion who received adjuvant chemotherapy increased from 27% (18-39) in 2004-2012 to 49% (40-58) in 2018-2022. Despite the increasing use of chemotherapy before and after liver resection, age- and sex-adjusted mortality remained essentially the same, with 1-year mortality ranging from 14% to 20% ( P -value = 0.37). In patients who underwent biliary tract resection, only 3% received downstaging chemotherapy, but the proportion who received adjuvant therapy increased from 17% (10-29) in 2004-2012 to 59% (48-68) in 2018-2022. Even so, these patients' age- and sex-adjusted mortality remained stable (1-year mortality ranging from 19% to 24%, P -value = 0.34).
CONCLUSION: The proportion of patients with cholangiocarcinoma who underwent liver or biliary tract resection increased, and more patients received downstaging chemotherapy and adjuvant chemotherapy. Nonetheless, age- and sex-adjusted mortality risks remained constant. The explanations for this pattern are unclear but likely involve changing patient characteristics other than age and sex.