Rak dróg żółciowych (cholangiocarcinoma) – Rokowania, prognozy i postęp choroby

Rak dróg żółciowych (cholangiocarcinoma)
Rokowania, prognozy i postęp choroby

Rak dróg żółciowych (cholangiocarcinoma) to agresywny nowotwór wywodzący się z nabłonka dróg żółciowych, charakteryzujący się złym rokowaniem, głównie z powodu późnej diagnozy i oporności na chemioterapię. Współczynniki 5-letniego względnego przeżycia wynoszą około 9% dla wewnątrzwątrobowego i 10% dla zewnątrzwątrobowego raka dróg żółciowych. Mediana całkowitego przeżycia u pacjentów z rakiem okołownękowym wynosi 5,2 miesiąca (95% CI 4,7-5,7), z 1-, 3- i 5-letnimi wskaźnikami przeżycia odpowiednio 31%, 10% i 6%. Rokowanie różni się w zależności od lokalizacji i stopnia zaawansowania: dla raka miejscowego 5-letnie przeżycie wynosi około 17-24%, dla regionalnego 9-16%, a dla odległego (stadium 4B) około 2%. Inwazja naczyniowa, zwłaszcza naciek żyły wrotnej lub tętnicy wątrobowej przekraczający 180°, jest istotnym negatywnym czynnikiem prognostycznym.

Rak dróg żółciowych (cholangiocarcinoma) – Prognoza (przewidywanie wyniku)

Wskaźniki przeżycia w raku dróg żółciowych
Wskaźniki przeżycia według lokalizacji i stopnia zaawansowania
Czynniki wpływające na rokowanie
Ograniczenia prognozowania i perspektywy
Kolejne rozdziały

Rak dróg żółciowych (cholangiocarcinoma) – Prognoza (przewidywanie wyniku)

Rak dróg żółciowych (cholangiocarcinoma) to heterogenna grupa nowotworów złośliwych wywodzących się z nabłonka dróg żółciowych, które mogą występować w dowolnym miejscu drzewa żółciowego ¹. Nowotwory te charakteryzują się szczególnie niekorzystnym rokowaniem ze względu na ich agresywny charakter, bezobjawowy przebieg we wczesnych stadiach oraz oporność na chemioterapię ²³. Pomimo zwiększonej świadomości, wiedzy, poprawy diagnostyki i terapii, rokowanie pacjentów z rakiem dróg żółciowych nie uległo znaczącej poprawie w ostatniej dekadzie ⁴.

Wskaźniki przeżycia w raku dróg żółciowych

Współczynniki przeżycia mogą dać wyobrażenie o odsetku osób z tym samym typem i stadium nowotworu, które nadal żyją przez określony czas (zwykle 5 lat) po rozpoznaniu. Informacje te nie mogą przewidzieć, jak długo będzie żył konkretny pacjent, ale mogą pomóc w lepszym zrozumieniu prawdopodobieństwa powodzenia leczenia ⁵. Należy pamiętać, że współczynniki przeżycia są szacunkami często opartymi na wcześniejszych wynikach dużej liczby osób z określonym nowotworem, ale nie mogą przewidzieć, co stanie się w każdym indywidualnym przypadku ⁶.

Rokowanie w raku dróg żółciowych jest zazwyczaj niekorzystne, ponieważ choroba często jest diagnozowana w zaawansowanych stadiach ⁷. Ogólne 5-letnie względne wskaźniki przeżycia wynoszą około 9% dla wewnątrzwątrobowego raka dróg żółciowych i 10% dla zewnątrzwątrobowego raka dróg żółciowych ⁸. Mediana całkowitego przeżycia w analizie przeprowadzonej na 2031 pacjentach z rakiem dróg żółciowych okołownękowym (perihilar cholangiocarcinoma) wynosiła zaledwie 5,2 miesiąca (95% CI 4,7-5,7), z 1-rocznym, 3-letnim i 5-letnim wskaźnikiem przeżycia odpowiednio 31%, 10% i 6% ⁹¹⁰.

Wskaźniki przeżycia według lokalizacji i stopnia zaawansowania

Rokowanie dla pacjentów z rakiem dróg żółciowych różni się w zależności od lokalizacji i stopnia zaawansowania choroby ¹¹. Współczynniki 5-letniego względnego przeżycia wahają się między 2-24% dla raków dróg żółciowych rozpoczynających się w wątrobie (wewnątrzwątrobowych) i 2-17% dla raków dróg żółciowych rozpoczynających się poza wątrobą (zewnątrzwątrobowych) ¹².

Dokładniejsze dane dotyczące przeżycia w zależności od stopnia zaawansowania przedstawiają się następująco:

Wewnątrzwątrobowy rak dróg żółciowych:

Rak miejscowy (stopień 0 i 1) – około 24% pacjentów żyje co najmniej 5 lat po diagnozie ¹³¹⁴
Rak regionalny – około 9% pacjentów żyje co najmniej 5 lat po diagnozie ¹⁵
Rak odległy (stadium 4B) – około 2% pacjentów żyje co najmniej 5 lat po diagnozie ¹⁶¹⁷

Zewnątrzwątrobowy rak dróg żółciowych:

Rak miejscowy – około 17% pacjentów żyje co najmniej 5 lat po diagnozie ¹⁸¹⁹
Rak regionalny – około 16% pacjentów żyje co najmniej 5 lat po diagnozie ²⁰
Rak odległy – około 2% pacjentów żyje co najmniej 5 lat po diagnozie ²¹²²

Czynniki wpływające na rokowanie

Rokowanie pacjentów z rakiem dróg żółciowych zależy od wielu czynników. Do najważniejszych należą:

Możliwość resekcji chirurgicznej

Resekcja chirurgiczna pozostaje jedyną metodą leczenia z intencją wyleczenia ²³. Mediana całkowitego przeżycia u pacjentów poddanych resekcji wynosi około 29,6 miesiąca (95% CI 25,2-34,0), w porównaniu do 12,2 miesiąca (95% CI 11,0-13,3) u pacjentów otrzymujących paliatywne leczenie systemowe i zaledwie 2,9 miesiąca (95% CI 2,6-3,2) u tych, którzy otrzymują jedynie najlepszą opiekę wspomagającą ²⁴. Kiedy możliwe jest całkowite chirurgiczne usunięcie nowotworu, około 40% pacjentów żyje co najmniej 5 lat po zabiegu ²⁵.

Celem leczenia chirurgicznego jest kompletna resekcja z negatywnymi marginesami (R0) i odpowiednim przyszłym fragmentem pozostałej wątroby ²⁶. U większości pacjentów wymagana jest (rozszerzona) hemihepatektomia z limfadenektomią obejmującą co najmniej sześć lokalnych węzłów chłonnych w celu odpowiedniej oceny zaawansowania ²⁷.

Liczba i wielkość guzów

W badaniu oceniającym długoterminowe wyniki po resekcji wewnątrzwątrobowego raka dróg żółciowych, mediana całkowitego przeżycia u pacjentów z pojedynczym guzem wynosiła 43,2 miesiąca, w porównaniu do 21,2 miesiąca u osób z dwoma guzami i 15,3 miesiąca u osób z trzema lub więcej guzami ²⁸. Większość pacjentów z wewnątrzwątrobowym rakiem dróg żółciowych ma duże guzy (mediana wielkości 6 cm), co niekorzystnie wpływa na rokowanie ²⁹.

Naciekanie naczyń

Inwazja naczyniowa jest istotnym negatywnym czynnikiem prognostycznym ³⁰. W szczególności, naciek radiologiczny żyły wrotnej głównej lub tętnicy wątrobowej wspólnej przekraczający 180° wiąże się ze złym rokowaniem ³¹.

Wiek i stan ogólny pacjenta

Młodszy wiek (poniżej 54 lat) jest związany z lepszym całkowitym przeżyciem u pacjentów z chorobą w stadium I-III ³². Ogólny stan zdrowia i sprawności pacjenta również wpływa na zastosowane leczenie i zdolność do radzenia sobie z nim ³³.

Leczenie systemowe

Chemioterapia może być związana z poprawą rokowania, ale tylko u pacjentów z chorobą w stadium III lub niższym ³⁴³⁵. Rola chemioradioterapii pozostaje niejasna i może być korzystna u pacjentów z rakiem okołownękowym lub dystalnym z mikroskopowo pozytywnymi marginesami chirurgicznymi (R1) lub innymi czynnikami wysokiego ryzyka, chociaż ten sposób postępowania wymaga potwierdzenia w badaniach prospektywnych ³⁶.

Markery biologiczne i czynniki molekularne

Ostatnie badania wskazują na potencjalną wartość prognostyczną nowych biomarkerów. Wykazano, że wysoka ekspresja TLR7, TLR9 i GATA3 wiąże się z dłuższym całkowitym przeżyciem ³⁷. W szczególności wysoka ekspresja TLR9 była również pozytywnie skorelowana z dłuższym czasem przeżycia wolnym od choroby ³⁸. W wieloczynnikowym modelu proporcjonalnego hazardu Coxa dla całkowitego przeżycia, wskaźnik TLR7/TLR9/GATA3 okazał się niezależnym czynnikiem prognostycznym ³⁹.

Głębsze zrozumienie pejzażu molekularnego i aktywowanych szlaków zaangażowanych w kancerogenezę raka dróg żółciowych pozwoliło rozpoznać podtypy tego nowotworu jako różne jednostki chorobowe ⁴⁰. Badania wykazały, że 10-20% pacjentów z rakiem dróg żółciowych wykazuje mutacje germinalne w genach predysponujących do raka ⁴¹.

Ograniczenia prognozowania i perspektywy

Należy pamiętać, że współczynniki przeżycia mają pewne ograniczenia ⁴²:

Dotyczą one tylko stadium nowotworu w momencie pierwszej diagnozy i nie mają zastosowania później, jeśli nowotwór rośnie, rozprzestrzenia się lub nawraca po leczeniu ⁴³
Są oparte na danych z przeszłości – osoby obecnie diagnozowane z rakiem dróg żółciowych mogą mieć lepsze rokowanie niż pokazują te liczby, ponieważ metody leczenia stale się poprawiają ⁴⁴⁴⁵
Dla rzadszych nowotworów, dane statystyczne opierają się na mniejszych liczbach, po prostu dlatego, że mniej osób ma tę chorobę, co może wpływać na ich dokładność ⁴⁶

Sposób, w jaki raki zachowują się i reagują na leczenie, różni się znacznie między poszczególnymi osobami. Zatem nawet jeśli dane liczbowe nie są tak korzystne jak oczekiwano, są one tylko średnią i poszczególni pacjenci mogą mieć znacznie lepsze wyniki ⁴⁷.

Eksperci nadal opracowują nowe metody leczenia nowotworów, więc rokowanie dla osób z rakiem dróg żółciowych może ulec zmianie w miarę dostępności nowszych terapii ⁴⁸. Obecna era badań omicznych umożliwia odkrywanie nowych i obiecujących biomarkerów w płynach ustrojowych (surowica, mocz, żółć, ślina) i tkance nowotworowej, które mogą zmienić paradygmat w diagnostyce i leczeniu choroby w nadchodzących latach ⁴⁹.

Leczenie raka dróg żółciowych wymaga obecnie dedykowanych ośrodków z multidyscyplinarną wiedzą specjalistyczną, które umożliwiają właściwe przeniesienie podstawowych badań do praktyki klinicznej ⁵⁰.

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Materiały źródłowe

#1 Cholangiocarcinoma 2020: the next horizon in mechanisms and management | Nature Reviews Gastroenterology & Hepatology
https://www.nature.com/articles/s41575-020-0310-z
Cholangiocarcinoma (CCA) includes a cluster of highly heterogeneous biliary malignant tumours that can arise at any point of the biliary tree. […] The silent presentation of these tumours combined with their highly aggressive nature and refractoriness to chemotherapy contribute to their alarming mortality, representing ~2% of all cancer-related deaths worldwide yearly. […] Despite advances in CCA awareness, knowledge, diagnosis and therapies, patient prognosis has not improved substantially in the past decade, with 5-year survival (720%) and tumour recurrence rates after resection still disappointing. […] Therefore, a detailed study of these types of cancers is urgently needed to improve patient welfare and outcomes. […] CCA is a rare cancer, but its incidence (0.36 per 100,000 inhabitants per year) and mortality (16 per 100,000 inhabitants per year, globally) have been increasing in the past few decades worldwide, representing a global health problem.
#2 Cholangiocarcinoma 2020: the next horizon in mechanisms and management | Nature Reviews Gastroenterology & Hepatology
https://www.nature.com/articles/s41575-020-0310-z
Cholangiocarcinoma (CCA) includes a cluster of highly heterogeneous biliary malignant tumours that can arise at any point of the biliary tree. […] The silent presentation of these tumours combined with their highly aggressive nature and refractoriness to chemotherapy contribute to their alarming mortality, representing ~2% of all cancer-related deaths worldwide yearly. […] Despite advances in CCA awareness, knowledge, diagnosis and therapies, patient prognosis has not improved substantially in the past decade, with 5-year survival (720%) and tumour recurrence rates after resection still disappointing. […] Therefore, a detailed study of these types of cancers is urgently needed to improve patient welfare and outcomes. […] CCA is a rare cancer, but its incidence (0.36 per 100,000 inhabitants per year) and mortality (16 per 100,000 inhabitants per year, globally) have been increasing in the past few decades worldwide, representing a global health problem.
#3 A Combined TLR7/TLR9/GATA3 Score Can Predict Prognosis in Biliary Tract Cancer
https://www.mdpi.com/2075-4418/11/9/1597
A Combined TLR7/TLR9/GATA3 Score Can Predict Prognosis in Biliary Tract Cancer […] The highly aggressive nature combined with its silent presentation contribute to the dismal prognosis of this tumor. […] These cancers have a dismal prognosis due to their aggressiveness and late diagnosis which severely compromises the effectiveness of available therapeutic options. […] The prognosis of BTC after surgical resection is still burdened by a relapse rate ranging from 50% to 70%. […] The survival analysis demonstrated that a high expression of TLR7, TLR9, and GATA3 was associated with longer overall survival. […] In particular, a high expression of TLR9 was also positively correlated with longer DFS. […] The univariate Cox regression analysis for OS indicated that a high expression of TLR7,9 and GATA3 was positively correlated with a better prognosis in BTC patients.
#4 Cholangiocarcinoma 2020: the next horizon in mechanisms and management | Nature Reviews Gastroenterology & Hepatology
https://www.nature.com/articles/s41575-020-0310-z
Cholangiocarcinoma (CCA) includes a cluster of highly heterogeneous biliary malignant tumours that can arise at any point of the biliary tree. […] The silent presentation of these tumours combined with their highly aggressive nature and refractoriness to chemotherapy contribute to their alarming mortality, representing ~2% of all cancer-related deaths worldwide yearly. […] Despite advances in CCA awareness, knowledge, diagnosis and therapies, patient prognosis has not improved substantially in the past decade, with 5-year survival (720%) and tumour recurrence rates after resection still disappointing. […] Therefore, a detailed study of these types of cancers is urgently needed to improve patient welfare and outcomes. […] CCA is a rare cancer, but its incidence (0.36 per 100,000 inhabitants per year) and mortality (16 per 100,000 inhabitants per year, globally) have been increasing in the past few decades worldwide, representing a global health problem.
#5 Bile Duct Cancer Survival Rates | Cholangiocarcinoma Survival Rates | American Cancer Society
https://www.cancer.org/cancer/types/bile-duct-cancer/detection-diagnosis-staging/survival-by-stage.html
Survival rates can give you an idea of what percentage of people with the same type and stage of cancer are still alive a certain amount of time (usually 5 years) after they were diagnosed. This information canât tell you how long you will live, but it may help give you a better understanding of how likely it is that your treatment will be successful. […] Keep in mind that survival rates are estimates and are often based on previous outcomes of large numbers of people who had a specific cancer, but they canât predict what will happen in any particular personâs case. […] For example, if the 5-year relative survival rate for a specific stage of bile duct cancer (cholangiocarcinoma) is 30%, it means people who have that cancer are, on average, about 30% as likely as people who donât have that cancer to live for at least 5 years after being diagnosed.
#6 Bile Duct Cancer Survival Rates | Cholangiocarcinoma Survival Rates | American Cancer Society
https://www.cancer.org/cancer/types/bile-duct-cancer/detection-diagnosis-staging/survival-by-stage.html
Survival rates can give you an idea of what percentage of people with the same type and stage of cancer are still alive a certain amount of time (usually 5 years) after they were diagnosed. This information canât tell you how long you will live, but it may help give you a better understanding of how likely it is that your treatment will be successful. […] Keep in mind that survival rates are estimates and are often based on previous outcomes of large numbers of people who had a specific cancer, but they canât predict what will happen in any particular personâs case. […] For example, if the 5-year relative survival rate for a specific stage of bile duct cancer (cholangiocarcinoma) is 30%, it means people who have that cancer are, on average, about 30% as likely as people who donât have that cancer to live for at least 5 years after being diagnosed.
#7 Prognosis for bile duct cancer: What to know
https://www.medicalnewstoday.com/articles/bile-duct-cancer-prognosis-2
Bile duct cancer occurs when cancerous cells form in the bile ducts. The prognosis for bile duct cancer is typically unfavorable because many people receive a diagnosis in the later stages of the disease. However, a persons prognosis depends on several factors, including their bodys response to treatment. […] The prognosis, also called the outlook, for people with bile duct cancer depends on its location and how advanced it is. […] The outlook for bile duct cancer is typically unfavorable. This is because the disease is often in the advanced stages when a person receives a diagnosis. […] A relative survival rate compares individuals with the same type and stage of cancer with people in the general population. For example, the 5-year relative survival rate for localized intrahepatic bile cancer is 24%. This means that people with that cancer are, on average, around 24% as likely as those without that type of cancer to live for at least 5 years after diagnosis.
#8 Bile Duct Cancer Stages and Survival Rate
https://www.cancercenter.com/cancer-types/bile-duct-cancer/stages
A cancers stage is an important metric in predicting patient outcomes. Each stage of cancer is given an average relative survival rate, which is usually based on the number of people with a certain type and stage of cancer who live five or more years after their diagnosis. Survival rates may provide helpful context, but they dont tell the full story. They are only estimates that reflect average outcomes of patients in the past. […] According to the American Cancer Society (ACS), approximately 8,000 bile duct cancers are diagnosed in the United States each year. The outcomes of these patients depend on the stage and type of bile duct cancer (intrahepatic and extrahepatic) and individual factors, such as age and medical history. […] According to the ACS, for intrahepatic bile duct cancer, the overall five-year relative survival rate across all stages is 9 percent, and for extrahepatic bile duct cancer, its 10 percent.
#9 Nationwide treatment and outcomes of perihilar cholangiocarcinoma
https://pmc.ncbi.nlm.nih.gov/articles/PMC8359996/
In a nationwide analysis on 2031 patients with perihilar cholangiocarcinoma, median overall survival was poor with 5.2 (95% CI 4.75.7) months. Surgical resection is the only curative treatment and was performed more frequently in patients diagnosed in academic hospitals (32%) compared to those in nonacademic centres 13%. Median overall survival was 29.6 (95% CI 25.234.0) months in the 310 (15%) patients who underwent surgical resection, 12.2 (95% CI 11.013.3) months in the 271 (13%) who underwent palliative systemic treatment, and 2.9 (95% CI 2.63.2) months in the 1429 (70%) who underwent best supportive care only. […] In patients with pCCA, resection rate and overall survival were higher for patients who were diagnosed in academic centres. These results show populationbased outcomes of pCCA and highlight the importance of regional collaboration in the treatment of these patients.
#10 Nationwide treatment and outcomes of perihilar cholangiocarcinoma
https://pmc.ncbi.nlm.nih.gov/articles/PMC8359996/
Median overall survival was 5.2 (95%CI 4.75.7) months, with 1, 3 and 5year survival rates of 31%, 10% and 6% respectively. Overall survival was dependent of age, gender, the presence of metastases, treatment and socioeconomic status. […] Overall survival differed according to the type of treatment. In total, 479 (24%) patients underwent surgical exploration, of which 169 (35%) patients were unresectable. Surgical exploration was associated with a median overall survival of 20.8 (95% CI 18.023.6) months and survival was 12.2 (95% CI 11.113.2) months in the subgroup of patients with unresectable tumours. A curativeintent resection was performed in 310 patients (15% of all patients) and median overall survival in these patients was 29.6 (95% CI 25.234.0) months. […] The overall survival benefit of patients diagnosed in academic centres can be partially attributed to the difference in resection rate between patients diagnosed in academic and nonacademic centres.
#11 Prognosis for bile duct cancer: What to know
https://www.medicalnewstoday.com/articles/bile-duct-cancer-prognosis-2
Bile duct cancer occurs when cancerous cells form in the bile ducts. The prognosis for bile duct cancer is typically unfavorable because many people receive a diagnosis in the later stages of the disease. However, a persons prognosis depends on several factors, including their bodys response to treatment. […] The prognosis, also called the outlook, for people with bile duct cancer depends on its location and how advanced it is. […] The outlook for bile duct cancer is typically unfavorable. This is because the disease is often in the advanced stages when a person receives a diagnosis. […] A relative survival rate compares individuals with the same type and stage of cancer with people in the general population. For example, the 5-year relative survival rate for localized intrahepatic bile cancer is 24%. This means that people with that cancer are, on average, around 24% as likely as those without that type of cancer to live for at least 5 years after diagnosis.
#12 Prognosis for bile duct cancer: What to know
https://www.medicalnewstoday.com/articles/bile-duct-cancer-prognosis-2
The 5-year relative survival rates range between 224% for bile duct cancers that start within the liver, and 217% for bile duct cancers that start outside the liver. People with localized bile duct cancer that has not spread within the body often have a more favorable outlook. […] In the early stages of bile duct cancer, doctors can sometimes remove all of the cancer with surgery. However, if the cancer spreads, it becomes more complex to treat. […] Most people receive a bile duct diagnosis in the later stages of the disease. In this case, healthcare professionals may offer them palliative care to alleviate their symptoms. […] Experts continue to develop new cancer treatments, so the outlook for people with bile duct cancer may change as newer treatments become available.
#13 Bile Duct Cancer Stages and Survival Rate
https://www.cancercenter.com/cancer-types/bile-duct-cancer/stages
However, as noted, survival rates vary depending on the stage: […] Localized intrahepatic bile duct cancers, which have not spread outside of the bile ducts (stages 0 and 1), have a five-year relative survival rate of 24 percent. […] For distant intrahepatic bile duct cancers, which have spread to distant areas or organs (stage 4B), the five-year relative survival rate is 2 percent. […] Distant extrahepatic bile duct cancers have a five-year relative survival rate of 2 percent, compared to a 17 percent relative survival rate for localized extrahepatic bile duct cancers.
#14 Outcomes (prognosis) for bile duct cancer treatment – Liver Cancer UK
https://livercanceruk.org/liver-cancer-information/types-of-liver-cancer/bile-duct-cancer/treating-bile-duct-cancer/outcomes-prognosis-after-bile-buct-cancer-treatment/
The statistics are separated into intrahepatic bile duct cancer and extrahepatic bile duct cancer. […] Intrahepatic outcomes by stage: Local â around 1 in 4 people (24%) lived for at least 5 years after their diagnosis; Regional â around 1 in 10 people (9%) lived for at least 5 years after their diagnosis; Distant â around 1 in 50 people (2%) lived for at least 5 years after their diagnosis. […] Extrahepatic outcomes by stage: Local â around 1 in 6 people (17%) lived for at least 5 years after their diagnosis; Regional â around 1 in 6 people (16%) lived for at least 5 years after their diagnosis; Distant â around 1 in 50 people (2%) lived for at least 5 years after their diagnosis. […] There are UK figures that group together all types and stages of bile duct cancer. These are slightly older than the figures above. Outcomes for people diagnosed more recently are likely to be better. […] In men, more than half (57%) lived for at least one year after their diagnosis; In women, around half (49%) lived for at least one year after their diagnosis.
#15 Outcomes (prognosis) for bile duct cancer treatment – Liver Cancer UK
https://livercanceruk.org/liver-cancer-information/types-of-liver-cancer/bile-duct-cancer/treating-bile-duct-cancer/outcomes-prognosis-after-bile-buct-cancer-treatment/
The statistics are separated into intrahepatic bile duct cancer and extrahepatic bile duct cancer. […] Intrahepatic outcomes by stage: Local â around 1 in 4 people (24%) lived for at least 5 years after their diagnosis; Regional â around 1 in 10 people (9%) lived for at least 5 years after their diagnosis; Distant â around 1 in 50 people (2%) lived for at least 5 years after their diagnosis. […] Extrahepatic outcomes by stage: Local â around 1 in 6 people (17%) lived for at least 5 years after their diagnosis; Regional â around 1 in 6 people (16%) lived for at least 5 years after their diagnosis; Distant â around 1 in 50 people (2%) lived for at least 5 years after their diagnosis. […] There are UK figures that group together all types and stages of bile duct cancer. These are slightly older than the figures above. Outcomes for people diagnosed more recently are likely to be better. […] In men, more than half (57%) lived for at least one year after their diagnosis; In women, around half (49%) lived for at least one year after their diagnosis.
#16 Bile Duct Cancer Stages and Survival Rate
https://www.cancercenter.com/cancer-types/bile-duct-cancer/stages
However, as noted, survival rates vary depending on the stage: […] Localized intrahepatic bile duct cancers, which have not spread outside of the bile ducts (stages 0 and 1), have a five-year relative survival rate of 24 percent. […] For distant intrahepatic bile duct cancers, which have spread to distant areas or organs (stage 4B), the five-year relative survival rate is 2 percent. […] Distant extrahepatic bile duct cancers have a five-year relative survival rate of 2 percent, compared to a 17 percent relative survival rate for localized extrahepatic bile duct cancers.
#17 Outcomes (prognosis) for bile duct cancer treatment – Liver Cancer UK
https://livercanceruk.org/liver-cancer-information/types-of-liver-cancer/bile-duct-cancer/treating-bile-duct-cancer/outcomes-prognosis-after-bile-buct-cancer-treatment/
The statistics are separated into intrahepatic bile duct cancer and extrahepatic bile duct cancer. […] Intrahepatic outcomes by stage: Local â around 1 in 4 people (24%) lived for at least 5 years after their diagnosis; Regional â around 1 in 10 people (9%) lived for at least 5 years after their diagnosis; Distant â around 1 in 50 people (2%) lived for at least 5 years after their diagnosis. […] Extrahepatic outcomes by stage: Local â around 1 in 6 people (17%) lived for at least 5 years after their diagnosis; Regional â around 1 in 6 people (16%) lived for at least 5 years after their diagnosis; Distant â around 1 in 50 people (2%) lived for at least 5 years after their diagnosis. […] There are UK figures that group together all types and stages of bile duct cancer. These are slightly older than the figures above. Outcomes for people diagnosed more recently are likely to be better. […] In men, more than half (57%) lived for at least one year after their diagnosis; In women, around half (49%) lived for at least one year after their diagnosis.
#18 Bile Duct Cancer Stages and Survival Rate
https://www.cancercenter.com/cancer-types/bile-duct-cancer/stages
However, as noted, survival rates vary depending on the stage: […] Localized intrahepatic bile duct cancers, which have not spread outside of the bile ducts (stages 0 and 1), have a five-year relative survival rate of 24 percent. […] For distant intrahepatic bile duct cancers, which have spread to distant areas or organs (stage 4B), the five-year relative survival rate is 2 percent. […] Distant extrahepatic bile duct cancers have a five-year relative survival rate of 2 percent, compared to a 17 percent relative survival rate for localized extrahepatic bile duct cancers.
#19 Outcomes (prognosis) for bile duct cancer treatment – Liver Cancer UK
https://livercanceruk.org/liver-cancer-information/types-of-liver-cancer/bile-duct-cancer/treating-bile-duct-cancer/outcomes-prognosis-after-bile-buct-cancer-treatment/
The statistics are separated into intrahepatic bile duct cancer and extrahepatic bile duct cancer. […] Intrahepatic outcomes by stage: Local â around 1 in 4 people (24%) lived for at least 5 years after their diagnosis; Regional â around 1 in 10 people (9%) lived for at least 5 years after their diagnosis; Distant â around 1 in 50 people (2%) lived for at least 5 years after their diagnosis. […] Extrahepatic outcomes by stage: Local â around 1 in 6 people (17%) lived for at least 5 years after their diagnosis; Regional â around 1 in 6 people (16%) lived for at least 5 years after their diagnosis; Distant â around 1 in 50 people (2%) lived for at least 5 years after their diagnosis. […] There are UK figures that group together all types and stages of bile duct cancer. These are slightly older than the figures above. Outcomes for people diagnosed more recently are likely to be better. […] In men, more than half (57%) lived for at least one year after their diagnosis; In women, around half (49%) lived for at least one year after their diagnosis.
#20 Outcomes (prognosis) for bile duct cancer treatment – Liver Cancer UK
https://livercanceruk.org/liver-cancer-information/types-of-liver-cancer/bile-duct-cancer/treating-bile-duct-cancer/outcomes-prognosis-after-bile-buct-cancer-treatment/
The statistics are separated into intrahepatic bile duct cancer and extrahepatic bile duct cancer. […] Intrahepatic outcomes by stage: Local â around 1 in 4 people (24%) lived for at least 5 years after their diagnosis; Regional â around 1 in 10 people (9%) lived for at least 5 years after their diagnosis; Distant â around 1 in 50 people (2%) lived for at least 5 years after their diagnosis. […] Extrahepatic outcomes by stage: Local â around 1 in 6 people (17%) lived for at least 5 years after their diagnosis; Regional â around 1 in 6 people (16%) lived for at least 5 years after their diagnosis; Distant â around 1 in 50 people (2%) lived for at least 5 years after their diagnosis. […] There are UK figures that group together all types and stages of bile duct cancer. These are slightly older than the figures above. Outcomes for people diagnosed more recently are likely to be better. […] In men, more than half (57%) lived for at least one year after their diagnosis; In women, around half (49%) lived for at least one year after their diagnosis.
#21 Bile Duct Cancer Stages and Survival Rate
https://www.cancercenter.com/cancer-types/bile-duct-cancer/stages
However, as noted, survival rates vary depending on the stage: […] Localized intrahepatic bile duct cancers, which have not spread outside of the bile ducts (stages 0 and 1), have a five-year relative survival rate of 24 percent. […] For distant intrahepatic bile duct cancers, which have spread to distant areas or organs (stage 4B), the five-year relative survival rate is 2 percent. […] Distant extrahepatic bile duct cancers have a five-year relative survival rate of 2 percent, compared to a 17 percent relative survival rate for localized extrahepatic bile duct cancers.
#22 Outcomes (prognosis) for bile duct cancer treatment – Liver Cancer UK
https://livercanceruk.org/liver-cancer-information/types-of-liver-cancer/bile-duct-cancer/treating-bile-duct-cancer/outcomes-prognosis-after-bile-buct-cancer-treatment/
The statistics are separated into intrahepatic bile duct cancer and extrahepatic bile duct cancer. […] Intrahepatic outcomes by stage: Local â around 1 in 4 people (24%) lived for at least 5 years after their diagnosis; Regional â around 1 in 10 people (9%) lived for at least 5 years after their diagnosis; Distant â around 1 in 50 people (2%) lived for at least 5 years after their diagnosis. […] Extrahepatic outcomes by stage: Local â around 1 in 6 people (17%) lived for at least 5 years after their diagnosis; Regional â around 1 in 6 people (16%) lived for at least 5 years after their diagnosis; Distant â around 1 in 50 people (2%) lived for at least 5 years after their diagnosis. […] There are UK figures that group together all types and stages of bile duct cancer. These are slightly older than the figures above. Outcomes for people diagnosed more recently are likely to be better. […] In men, more than half (57%) lived for at least one year after their diagnosis; In women, around half (49%) lived for at least one year after their diagnosis.
#23 Nationwide treatment and outcomes of perihilar cholangiocarcinoma
https://pmc.ncbi.nlm.nih.gov/articles/PMC8359996/
In a nationwide analysis on 2031 patients with perihilar cholangiocarcinoma, median overall survival was poor with 5.2 (95% CI 4.75.7) months. Surgical resection is the only curative treatment and was performed more frequently in patients diagnosed in academic hospitals (32%) compared to those in nonacademic centres 13%. Median overall survival was 29.6 (95% CI 25.234.0) months in the 310 (15%) patients who underwent surgical resection, 12.2 (95% CI 11.013.3) months in the 271 (13%) who underwent palliative systemic treatment, and 2.9 (95% CI 2.63.2) months in the 1429 (70%) who underwent best supportive care only. […] In patients with pCCA, resection rate and overall survival were higher for patients who were diagnosed in academic centres. These results show populationbased outcomes of pCCA and highlight the importance of regional collaboration in the treatment of these patients.
#24 Nationwide treatment and outcomes of perihilar cholangiocarcinoma
https://pmc.ncbi.nlm.nih.gov/articles/PMC8359996/
In a nationwide analysis on 2031 patients with perihilar cholangiocarcinoma, median overall survival was poor with 5.2 (95% CI 4.75.7) months. Surgical resection is the only curative treatment and was performed more frequently in patients diagnosed in academic hospitals (32%) compared to those in nonacademic centres 13%. Median overall survival was 29.6 (95% CI 25.234.0) months in the 310 (15%) patients who underwent surgical resection, 12.2 (95% CI 11.013.3) months in the 271 (13%) who underwent palliative systemic treatment, and 2.9 (95% CI 2.63.2) months in the 1429 (70%) who underwent best supportive care only. […] In patients with pCCA, resection rate and overall survival were higher for patients who were diagnosed in academic centres. These results show populationbased outcomes of pCCA and highlight the importance of regional collaboration in the treatment of these patients.
#25 Outcomes (prognosis) for bile duct cancer treatment – Liver Cancer UK
https://livercanceruk.org/liver-cancer-information/types-of-liver-cancer/bile-duct-cancer/treating-bile-duct-cancer/outcomes-prognosis-after-bile-buct-cancer-treatment/
Of course, some people do very well after treatment for bile duct cancer. The way cancers behave and respond to treatment varies a great deal between people. So even if the figures arenât what youâd hoped for, they are only an average and you may do a lot better. Generally speaking though, bile duct cancer that is diagnosed at an advanced stage is less likely to be controlled for long periods. […] Finally, remember that survival statistics are always looking back at what happened in the past. Treatment for cancer is improving all the time, so patients diagnosed now may do better than patients diagnosed some years ago. […] The most important thing is whether you can have an operation to completely remove the cancer and try to cure it. With this type of treatment, around 4 out of 10 people (40%) live for at least 5 years afterwards.
#26 Cholangiocarcinoma 2020: the next horizon in mechanisms and management | Nature Reviews Gastroenterology & Hepatology
https://www.nature.com/articles/s41575-020-0310-z
The role of chemoradiotherapy remains unclear and might be of benefit in patients with pCCA or dCCA with microscopic positive surgical margins (R1) or other high-risk factors, although this approach needs to be confirmed in prospective studies. […] The majority of patients with iCCA present with large tumours (median size 6cm). […] The goal of surgery is a complete margin-negative resection (R0) with an adequate future liver remnant. […] Most patients require an (extended) hemi-hepatectomy with lymphadenectomy of at least six locoregional lymph nodes for adequate staging. […] The presence of cancer-related symptoms (such as abdominal pain or malaise) or the degree of liver function impairment can also affect prognosis. […] The current omics era is enabling the discovery of new and promising biomarkers in biofluids (serum, urine, bile, saliva) and tumour tissue that could change the paradigm in disease diagnosis and management in the upcoming years.
#27 Cholangiocarcinoma 2020: the next horizon in mechanisms and management | Nature Reviews Gastroenterology & Hepatology
https://www.nature.com/articles/s41575-020-0310-z
The role of chemoradiotherapy remains unclear and might be of benefit in patients with pCCA or dCCA with microscopic positive surgical margins (R1) or other high-risk factors, although this approach needs to be confirmed in prospective studies. […] The majority of patients with iCCA present with large tumours (median size 6cm). […] The goal of surgery is a complete margin-negative resection (R0) with an adequate future liver remnant. […] Most patients require an (extended) hemi-hepatectomy with lymphadenectomy of at least six locoregional lymph nodes for adequate staging. […] The presence of cancer-related symptoms (such as abdominal pain or malaise) or the degree of liver function impairment can also affect prognosis. […] The current omics era is enabling the discovery of new and promising biomarkers in biofluids (serum, urine, bile, saliva) and tumour tissue that could change the paradigm in disease diagnosis and management in the upcoming years.
#28 Cholangiocarcinoma 2020: the next horizon in mechanisms and management | Nature Reviews Gastroenterology & Hepatology
https://www.nature.com/articles/s41575-020-0310-z
CCAs are usually asymptomatic in early stages and, therefore, often diagnosed when the disease is already in advanced stages, which highly compromises therapeutic options, resulting in a dismal prognosis. […] The three subtypes of CCA can have different risk factors, pathobiology, clinical presentations, management and prognosis, as well as distinct epidemiological trends. […] The presence of Bismuth type IV pCCA (involving both the right and left intrahepatic ducts) is no longer an absolute contraindication for complete resection since it is associated with an OS similar to that in patients with less extensive biliary extension. […] However, tumour abutment on imaging of the main portal vein or common hepatic artery exceeding 180 is associated with a poor prognosis. […] In a study investigating long-term outcomes after resection of iCCA, the median OS in patients with a solitary iCCA was 43.2 months, versus 21.2 months in those with two tumours and 15.3 months in those with three or more tumours.
#29 Cholangiocarcinoma 2020: the next horizon in mechanisms and management | Nature Reviews Gastroenterology & Hepatology
https://www.nature.com/articles/s41575-020-0310-z
The role of chemoradiotherapy remains unclear and might be of benefit in patients with pCCA or dCCA with microscopic positive surgical margins (R1) or other high-risk factors, although this approach needs to be confirmed in prospective studies. […] The majority of patients with iCCA present with large tumours (median size 6cm). […] The goal of surgery is a complete margin-negative resection (R0) with an adequate future liver remnant. […] Most patients require an (extended) hemi-hepatectomy with lymphadenectomy of at least six locoregional lymph nodes for adequate staging. […] The presence of cancer-related symptoms (such as abdominal pain or malaise) or the degree of liver function impairment can also affect prognosis. […] The current omics era is enabling the discovery of new and promising biomarkers in biofluids (serum, urine, bile, saliva) and tumour tissue that could change the paradigm in disease diagnosis and management in the upcoming years.
#30 Prognostic factors in patients with intrahepatic cholangiocarcinoma | Scientific Reports
https://www.nature.com/articles/s41598-024-70124-z
Intrahepatic cholangiocarcinoma (ICC) is the second commonly-seen liver malignancy and one of the most fatal cancers in Taiwan. Survival after diagnosis of ICC remains poor. This study aimed to investigate the survival and prognostic factors in patients with ICC. The 3-, 5-year OS rates were 44.0%, 36.4% in the surgical group and 26.0%, 23.7% in the non-surgical group, respectively. Surgery, young patients (54 years), small tumor size, no vascular invasion and chemotherapy were associated with better OS in patients with stages IIII disease. Long-term survival in patients with ICC is very poor. Compared to non-surgical patients, surgery conveys approximately 18% and 12% better OS rates at 3-year and 5-year, respectively. Early detection and surgical intervention may improve OS substantially in patients with ICC.
#31 Cholangiocarcinoma 2020: the next horizon in mechanisms and management | Nature Reviews Gastroenterology & Hepatology
https://www.nature.com/articles/s41575-020-0310-z
CCAs are usually asymptomatic in early stages and, therefore, often diagnosed when the disease is already in advanced stages, which highly compromises therapeutic options, resulting in a dismal prognosis. […] The three subtypes of CCA can have different risk factors, pathobiology, clinical presentations, management and prognosis, as well as distinct epidemiological trends. […] The presence of Bismuth type IV pCCA (involving both the right and left intrahepatic ducts) is no longer an absolute contraindication for complete resection since it is associated with an OS similar to that in patients with less extensive biliary extension. […] However, tumour abutment on imaging of the main portal vein or common hepatic artery exceeding 180 is associated with a poor prognosis. […] In a study investigating long-term outcomes after resection of iCCA, the median OS in patients with a solitary iCCA was 43.2 months, versus 21.2 months in those with two tumours and 15.3 months in those with three or more tumours.
#32 Prognostic factors in patients with intrahepatic cholangiocarcinoma | Scientific Reports
https://www.nature.com/articles/s41598-024-70124-z
Intrahepatic cholangiocarcinoma (ICC) is the second commonly-seen liver malignancy and one of the most fatal cancers in Taiwan. Survival after diagnosis of ICC remains poor. This study aimed to investigate the survival and prognostic factors in patients with ICC. The 3-, 5-year OS rates were 44.0%, 36.4% in the surgical group and 26.0%, 23.7% in the non-surgical group, respectively. Surgery, young patients (54 years), small tumor size, no vascular invasion and chemotherapy were associated with better OS in patients with stages IIII disease. Long-term survival in patients with ICC is very poor. Compared to non-surgical patients, surgery conveys approximately 18% and 12% better OS rates at 3-year and 5-year, respectively. Early detection and surgical intervention may improve OS substantially in patients with ICC.
#33 Outcomes (prognosis) for bile duct cancer treatment – Liver Cancer UK
https://livercanceruk.org/liver-cancer-information/types-of-liver-cancer/bile-duct-cancer/treating-bile-duct-cancer/outcomes-prognosis-after-bile-buct-cancer-treatment/
Understandably, the first question that many patients ask after a cancer diagnosis is âwhat is the prognosis?â. […] This can be a difficult question for doctors to answer. No statistics will tell you what will happen in your case. They can only give you an idea of what happens in general. […] How well someone does after a cancer diagnosis depends on a number of different things â which is why you canât assume that statistics apply to you as an individual. It will depend on: how early the cancer is diagnosed, how big it is and where itâs growing; the treatment you have, for example whether the cancer can be removed; your age and general health and fitness, as this affects the treatment you have and how well you cope with it. […] Statistics are put together looking at large groups of people and recording how they do. For rarer cancers, the stats are based on smaller numbers, simply because fewer people have the condition. Because theyâre based on smaller numbers, they may not be as accurate. So itâs fine to look for outcome stats, but do remember that they are only ever a guide.
#34 Prognostic factors in patients with intrahepatic cholangiocarcinoma | Scientific Reports
https://www.nature.com/articles/s41598-024-70124-z
Intrahepatic cholangiocarcinoma (ICC) is the second commonly-seen liver malignancy and one of the most fatal cancers in Taiwan. Survival after diagnosis of ICC remains poor. This study aimed to investigate the survival and prognostic factors in patients with ICC. The 3-, 5-year OS rates were 44.0%, 36.4% in the surgical group and 26.0%, 23.7% in the non-surgical group, respectively. Surgery, young patients (54 years), small tumor size, no vascular invasion and chemotherapy were associated with better OS in patients with stages IIII disease. Long-term survival in patients with ICC is very poor. Compared to non-surgical patients, surgery conveys approximately 18% and 12% better OS rates at 3-year and 5-year, respectively. Early detection and surgical intervention may improve OS substantially in patients with ICC.
#35 Prognostic factors in patients with intrahepatic cholangiocarcinoma | Scientific Reports
https://www.nature.com/articles/s41598-024-70124-z
[…] The majority of patients have unresectable disease and surgery is effective in only 25% to 30% of patients. The effect of adjuvant therapy (chemotherapy/radiotherapy) is inconclusive for patients with ICC who either did or did not undergo surgery. Given patients with ICC have a poor prognosis and no adequate treatment options, studies that can clarify their survival and prognostic factors are important and informative. […] […] Long-term outcomes for patients with ICC were poor as observed in the current study. Intrahepatic cholangiocarcinoma accounted for less than 8% of primary liver malignancy, and only 32.3% of patients with ICC could initially be managed with liver resection. Most patients (55.6%) presented with stage IV disease when first diagnosed. Surgery was associated with better outcomes for patients with all stages, though surgical benefit attenuated as stage aggravated. Chemotherapy might be associated with improved prognosis only in patients with disease of stage III or less.
#36 Cholangiocarcinoma 2020: the next horizon in mechanisms and management | Nature Reviews Gastroenterology & Hepatology
https://www.nature.com/articles/s41575-020-0310-z
The role of chemoradiotherapy remains unclear and might be of benefit in patients with pCCA or dCCA with microscopic positive surgical margins (R1) or other high-risk factors, although this approach needs to be confirmed in prospective studies. […] The majority of patients with iCCA present with large tumours (median size 6cm). […] The goal of surgery is a complete margin-negative resection (R0) with an adequate future liver remnant. […] Most patients require an (extended) hemi-hepatectomy with lymphadenectomy of at least six locoregional lymph nodes for adequate staging. […] The presence of cancer-related symptoms (such as abdominal pain or malaise) or the degree of liver function impairment can also affect prognosis. […] The current omics era is enabling the discovery of new and promising biomarkers in biofluids (serum, urine, bile, saliva) and tumour tissue that could change the paradigm in disease diagnosis and management in the upcoming years.
#37 A Combined TLR7/TLR9/GATA3 Score Can Predict Prognosis in Biliary Tract Cancer
https://www.mdpi.com/2075-4418/11/9/1597
A Combined TLR7/TLR9/GATA3 Score Can Predict Prognosis in Biliary Tract Cancer […] The highly aggressive nature combined with its silent presentation contribute to the dismal prognosis of this tumor. […] These cancers have a dismal prognosis due to their aggressiveness and late diagnosis which severely compromises the effectiveness of available therapeutic options. […] The prognosis of BTC after surgical resection is still burdened by a relapse rate ranging from 50% to 70%. […] The survival analysis demonstrated that a high expression of TLR7, TLR9, and GATA3 was associated with longer overall survival. […] In particular, a high expression of TLR9 was also positively correlated with longer DFS. […] The univariate Cox regression analysis for OS indicated that a high expression of TLR7,9 and GATA3 was positively correlated with a better prognosis in BTC patients.
#38 A Combined TLR7/TLR9/GATA3 Score Can Predict Prognosis in Biliary Tract Cancer
https://www.mdpi.com/2075-4418/11/9/1597
A Combined TLR7/TLR9/GATA3 Score Can Predict Prognosis in Biliary Tract Cancer […] The highly aggressive nature combined with its silent presentation contribute to the dismal prognosis of this tumor. […] These cancers have a dismal prognosis due to their aggressiveness and late diagnosis which severely compromises the effectiveness of available therapeutic options. […] The prognosis of BTC after surgical resection is still burdened by a relapse rate ranging from 50% to 70%. […] The survival analysis demonstrated that a high expression of TLR7, TLR9, and GATA3 was associated with longer overall survival. […] In particular, a high expression of TLR9 was also positively correlated with longer DFS. […] The univariate Cox regression analysis for OS indicated that a high expression of TLR7,9 and GATA3 was positively correlated with a better prognosis in BTC patients.
#39 A Combined TLR7/TLR9/GATA3 Score Can Predict Prognosis in Biliary Tract Cancer
https://www.mdpi.com/2075-4418/11/9/1597
A score was calculated using the three markers with the best prognostic significance for overall survival (TLR7, TLR9, GATA3). […] In the multivariate Cox proportional-hazards model for OS, the TLR7/TLR9/GATA3 score was found to be an independent prognostic factor for OS. […] In the univariate analysis for DFS, TLR9 was the only marker significantly associated with DFS and therefore the only one added to the multivariate Cox proportional-hazards model for DFS.
#40 Biliary tract cancer prognostic and predictive genomics
https://pmc.ncbi.nlm.nih.gov/articles/PMC7910699/
Germline analysis in BTC patients in view of screening and therapeutic implications. […] A deeper understanding of the molecular landscape and activated pathways involved in the carcinogenesis of BTCs has enabled to recognize BTCs subtypes as different entities. […] Furthermore, it has also guided the development of several novel drugs, which has derived into multiple ongoing phase II and III trials. […] Some of these trials have already shown preliminary efficacy on clinical outcomes and represent one step further towards becoming a standard treatment.
#41 Biliary tract cancer prognostic and predictive genomics
https://pmc.ncbi.nlm.nih.gov/articles/PMC7910699/
Biliary tract cancer (BTC) is comprised of intrahepatic cholangiocarcinoma (ICC), extrahepatic cholangiocarcinoma (EHC) and gallbladder cancer (GBC). […] These tumors arise in the biliary epithelium, share histological characteristics and are associated with grim prognosis even when diagnosed at early stages. […] All BTCs arise in the biliary epithelium; they are associated with poor outcomes even when diagnosed at early stage. […] Although BTCs share some histological characteristics and features, there are important differences among them in terms of disease behavior, molecular profiles, and sensitivity to therapy. […] For example, GBC has been associated with worse prognosis compared to cholangiocarcinoma, however it has a greater response rate to chemotherapy. […] Studies have determined that 10-20% of BTC patients display germline mutations on cancer-prone genes.
#42 Outcomes (prognosis) for bile duct cancer treatment – Liver Cancer UK
https://livercanceruk.org/liver-cancer-information/types-of-liver-cancer/bile-duct-cancer/treating-bile-duct-cancer/outcomes-prognosis-after-bile-buct-cancer-treatment/
Understandably, the first question that many patients ask after a cancer diagnosis is âwhat is the prognosis?â. […] This can be a difficult question for doctors to answer. No statistics will tell you what will happen in your case. They can only give you an idea of what happens in general. […] How well someone does after a cancer diagnosis depends on a number of different things â which is why you canât assume that statistics apply to you as an individual. It will depend on: how early the cancer is diagnosed, how big it is and where itâs growing; the treatment you have, for example whether the cancer can be removed; your age and general health and fitness, as this affects the treatment you have and how well you cope with it. […] Statistics are put together looking at large groups of people and recording how they do. For rarer cancers, the stats are based on smaller numbers, simply because fewer people have the condition. Because theyâre based on smaller numbers, they may not be as accurate. So itâs fine to look for outcome stats, but do remember that they are only ever a guide.
#43 Bile Duct Cancer Survival Rates | Cholangiocarcinoma Survival Rates | American Cancer Society
https://www.cancer.org/cancer/types/bile-duct-cancer/detection-diagnosis-staging/survival-by-stage.html
These numbers apply only to the stage of the cancer when it is first diagnosed. They do not apply later on if the cancer grows, spreads, or comes back after treatment. […] People now being diagnosed with bile duct cancer may have a better outlook than these numbers show. Treatments improve over time, and these numbers are based on people who were diagnosed and treated at least five years earlier.
#44 Bile Duct Cancer Survival Rates | Cholangiocarcinoma Survival Rates | American Cancer Society
https://www.cancer.org/cancer/types/bile-duct-cancer/detection-diagnosis-staging/survival-by-stage.html
These numbers apply only to the stage of the cancer when it is first diagnosed. They do not apply later on if the cancer grows, spreads, or comes back after treatment. […] People now being diagnosed with bile duct cancer may have a better outlook than these numbers show. Treatments improve over time, and these numbers are based on people who were diagnosed and treated at least five years earlier.
#45 Outcomes (prognosis) for bile duct cancer treatment – Liver Cancer UK
https://livercanceruk.org/liver-cancer-information/types-of-liver-cancer/bile-duct-cancer/treating-bile-duct-cancer/outcomes-prognosis-after-bile-buct-cancer-treatment/
Of course, some people do very well after treatment for bile duct cancer. The way cancers behave and respond to treatment varies a great deal between people. So even if the figures arenât what youâd hoped for, they are only an average and you may do a lot better. Generally speaking though, bile duct cancer that is diagnosed at an advanced stage is less likely to be controlled for long periods. […] Finally, remember that survival statistics are always looking back at what happened in the past. Treatment for cancer is improving all the time, so patients diagnosed now may do better than patients diagnosed some years ago. […] The most important thing is whether you can have an operation to completely remove the cancer and try to cure it. With this type of treatment, around 4 out of 10 people (40%) live for at least 5 years afterwards.
#46 Outcomes (prognosis) for bile duct cancer treatment – Liver Cancer UK
https://livercanceruk.org/liver-cancer-information/types-of-liver-cancer/bile-duct-cancer/treating-bile-duct-cancer/outcomes-prognosis-after-bile-buct-cancer-treatment/
Understandably, the first question that many patients ask after a cancer diagnosis is âwhat is the prognosis?â. […] This can be a difficult question for doctors to answer. No statistics will tell you what will happen in your case. They can only give you an idea of what happens in general. […] How well someone does after a cancer diagnosis depends on a number of different things â which is why you canât assume that statistics apply to you as an individual. It will depend on: how early the cancer is diagnosed, how big it is and where itâs growing; the treatment you have, for example whether the cancer can be removed; your age and general health and fitness, as this affects the treatment you have and how well you cope with it. […] Statistics are put together looking at large groups of people and recording how they do. For rarer cancers, the stats are based on smaller numbers, simply because fewer people have the condition. Because theyâre based on smaller numbers, they may not be as accurate. So itâs fine to look for outcome stats, but do remember that they are only ever a guide.
#47 Outcomes (prognosis) for bile duct cancer treatment – Liver Cancer UK
https://livercanceruk.org/liver-cancer-information/types-of-liver-cancer/bile-duct-cancer/treating-bile-duct-cancer/outcomes-prognosis-after-bile-buct-cancer-treatment/
Of course, some people do very well after treatment for bile duct cancer. The way cancers behave and respond to treatment varies a great deal between people. So even if the figures arenât what youâd hoped for, they are only an average and you may do a lot better. Generally speaking though, bile duct cancer that is diagnosed at an advanced stage is less likely to be controlled for long periods. […] Finally, remember that survival statistics are always looking back at what happened in the past. Treatment for cancer is improving all the time, so patients diagnosed now may do better than patients diagnosed some years ago. […] The most important thing is whether you can have an operation to completely remove the cancer and try to cure it. With this type of treatment, around 4 out of 10 people (40%) live for at least 5 years afterwards.
#48 Prognosis for bile duct cancer: What to know
https://www.medicalnewstoday.com/articles/bile-duct-cancer-prognosis-2
The 5-year relative survival rates range between 224% for bile duct cancers that start within the liver, and 217% for bile duct cancers that start outside the liver. People with localized bile duct cancer that has not spread within the body often have a more favorable outlook. […] In the early stages of bile duct cancer, doctors can sometimes remove all of the cancer with surgery. However, if the cancer spreads, it becomes more complex to treat. […] Most people receive a bile duct diagnosis in the later stages of the disease. In this case, healthcare professionals may offer them palliative care to alleviate their symptoms. […] Experts continue to develop new cancer treatments, so the outlook for people with bile duct cancer may change as newer treatments become available.
#49 Cholangiocarcinoma 2020: the next horizon in mechanisms and management | Nature Reviews Gastroenterology & Hepatology
https://www.nature.com/articles/s41575-020-0310-z
The role of chemoradiotherapy remains unclear and might be of benefit in patients with pCCA or dCCA with microscopic positive surgical margins (R1) or other high-risk factors, although this approach needs to be confirmed in prospective studies. […] The majority of patients with iCCA present with large tumours (median size 6cm). […] The goal of surgery is a complete margin-negative resection (R0) with an adequate future liver remnant. […] Most patients require an (extended) hemi-hepatectomy with lymphadenectomy of at least six locoregional lymph nodes for adequate staging. […] The presence of cancer-related symptoms (such as abdominal pain or malaise) or the degree of liver function impairment can also affect prognosis. […] The current omics era is enabling the discovery of new and promising biomarkers in biofluids (serum, urine, bile, saliva) and tumour tissue that could change the paradigm in disease diagnosis and management in the upcoming years.
#50 Cholangiocarcinoma 2020: the next horizon in mechanisms and management | Nature Reviews Gastroenterology & Hepatology
https://www.nature.com/articles/s41575-020-0310-z
The known risk factors for CCA are only involved in 20% of cases, indicating the urgent need to ascertain other causes of disease to improve awareness and screening policies for early diagnosis, which might substantially influence patient outcomes. […] CCA management nowadays requires dedicated centres with multidisciplinary expertise that enable the proper translation of basic investigations to clinical practice. […] CCA is still an open field of research, with important gaps that need to be filled.