Rak dróg żółciowych – Rokowania, prognozy i postęp choroby

Rak dróg żółciowych
Rokowania, prognozy i postęp choroby

Rak dróg żółciowych (cholangiocarcinoma) cechuje się wysoką agresywnością i szybkim rozprzestrzenianiem, co skutkuje niekorzystnym rokowaniem. Pięcioletnie wskaźniki przeżycia wahają się od 18-23% w przypadku nowotworów ograniczonych do dróg żółciowych, do zaledwie 2-3% przy obecności rozsiewu. Według American Cancer Society, 5-letni względny wskaźnik przeżycia wynosi 9% dla wewnątrzwątrobowego i 10% dla zewnątrzwątrobowego raka dróg żółciowych, z wyraźnym pogorszeniem w zaawansowanych stadiach (np. 2% dla stadium 4B). Czynniki prognostyczne obejmują możliwość całkowitej resekcji chirurgicznej (R0), lokalizację guza, stopień zaawansowania, obecność przerzutów w węzłach chłonnych, typ histologiczny oraz cechy pacjenta, takie jak wiek i ogólny stan zdrowia. Mediana przeżycia w raku wnęki wątroby wynosi około 5,2 miesiąca, z 5-letnim wskaźnikiem przeżycia na poziomie 6%.

Prognoza w raku dróg żółciowych (cholangiocarcinoma)

Wskaźniki przeżycia w raku dróg żółciowych
Czynniki prognostyczne wpływające na rokowanie
Możliwość wyleczenia raka dróg żółciowych
Właściwa interpretacja wskaźników przeżycia
Nowe perspektywy w leczeniu i rokowaniu
Kolejne rozdziały

Prognoza w raku dróg żółciowych (cholangiocarcinoma)

Rak dróg żółciowych (cholangiocarcinoma) charakteryzuje się wysoką agresywnością i szybkim rozprzestrzenianiem się, co przekłada się na niekorzystne rokowanie. Większość pacjentów otrzymuje diagnozę w zaawansowanym stadium choroby, gdy nowotwór zdążył już rozprzestrzenić się poza drogi żółciowe, co znacząco utrudnia leczenie i pogarsza szanse na przeżycie.¹² Bezobjawowy przebieg we wczesnych stadiach, wysoka agresywność nowotworu oraz oporność na chemioterapię przyczyniają się do alarmującej śmiertelności, odpowiadającej za około 2% wszystkich zgonów związanych z nowotworami na całym świecie.³

Wskaźniki przeżycia w raku dróg żółciowych

Pięcioletnie wskaźniki przeżycia w raku dróg żółciowych są nadal niezadowalające. Zgodnie z danymi statystycznymi, 5-letni wskaźnik przeżycia dla chorych z rakiem dróg żółciowych, który nie rozprzestrzenił się poza drogi żółciowe, waha się w zakresie 18-23%. Ten wskaźnik spada dramatycznie do 2-3% dla nowotworów, które zdążyły się rozprzestrzenić poza drogi żółciowe.⁴ Warto jednak zaznaczyć, że wskaźniki te opierają się na danych z wcześniejszych lat i nie odzwierciedlają najnowszych postępów w leczeniu.⁵⁶

Według American Cancer Society (ACS), ogólny 5-letni względny wskaźnik przeżycia dla wewnątrzwątrobowego raka dróg żółciowych wynosi 9%, a dla zewnątrzwątrobowego raka dróg żółciowych 10%.⁷ Wskaźniki przeżycia silnie zależą od stadium nowotworu:

Zlokalizowane wewnątrzwątrobowe raki dróg żółciowych (stadium 0 i 1), które nie rozprzestrzeniły się poza drogi żółciowe, mają 5-letni względny wskaźnik przeżycia wynoszący 24%
Dla odległych wewnątrzwątrobowych raków dróg żółciowych (stadium 4B), które rozprzestrzeniły się do odległych narządów, 5-letni względny wskaźnik przeżycia wynosi zaledwie 2%
Odległe zewnątrzwątrobowe raki dróg żółciowych mają 5-letni względny wskaźnik przeżycia wynoszący 2%, w porównaniu do 17% dla zlokalizowanych zewnątrzwątrobowych raków dróg żółciowych

⁸

Badania brytyjskiego Cancer Research UK podają nieco odmienne dane w zależności od umiejscowienia nowotworu: prawie 25% pacjentów przeżywa 5 lat lub więcej w przypadku raka wewnątrzwątrobowego, około 10% w przypadku raka wnęki wątroby (hilum), prawie 5% w przypadku raka dystalnej części dróg żółciowych, a prawie 20% w przypadku raka dużych dróg żółciowych.⁹ Jednocześnie tylko 2% pacjentów z rozsianym rakiem dróg żółciowych przeżywa 5 lat lub więcej po diagnozie.¹⁰

Holenderskie badanie z udziałem 2031 pacjentów z rakiem dróg żółciowych okolicy wnęki wątroby (perihilar cholangiocarcinoma) wykazało, że mediana całkowitego przeżycia wynosiła 5,2 miesiąca (95% CI 4,7-5,7), z 1-rocznym, 3-letnim i 5-letnim wskaźnikiem przeżycia odpowiednio 31%, 10% i 6%.¹¹

Czynniki prognostyczne wpływające na rokowanie

Rokowanie w raku dróg żółciowych zależy od wielu czynników, a zrozumienie ich pozwala lekarzom na lepsze przewidywanie przebiegu choroby i dostosowanie leczenia.¹² Do najważniejszych czynników prognostycznych należą:

Możliwość przeprowadzenia resekcji chirurgicznej

Chirurgiczne usunięcie nowotworu jest najskuteczniejszą metodą leczenia raka dróg żółciowych, dlatego możliwość całkowitej resekcji stanowi najważniejszy czynnik prognostyczny.¹³ Guzy, które można całkowicie usunąć chirurgicznie (resekcyjne), mają znacznie korzystniejsze rokowanie niż guzy nieresekcyjne. Nowotwory we wczesnym stadium, mniejsze guzy lub te, które nie rozprzestrzeniły się do innych narządów, mają największe szanse na całkowitą resekcję.¹⁴

Uzyskanie ujemnych marginesów chirurgicznych (R0) podczas resekcji stanowi istotny czynnik prognostyczny we wszystkich podgrupach raka dróg żółciowych, co potwierdzają wszystkie duże serie chirurgiczne.¹⁵ Niektóre badania sugerują, że tylko obecność raka inwazyjnego, a nie raka in situ na marginesie resekcji dróg żółciowych, znacząco wpływa na przeżycie pacjentów z wnękowym i/lub dystalnym zewnątrzwątrobowym rakiem dróg żółciowych.¹⁶

Wskaźnik resekcji w ośrodkach akademickich wynosi około 32% i jest podobny do wcześniej publikowanych wskaźników resekcji w doświadczonych ośrodkach, które wahają się od 30% do 34%. Jednak ogólny wskaźnik resekcji wynoszący 15% jest niższy niż zwykle podawany.¹⁷

Stadium zaawansowania choroby

Osoby z wczesnym stadium raka dróg żółciowych mają lepsze rokowanie niż osoby z zaawansowanym nowotworem. Guzy, które nadal znajdują się w najbardziej wewnętrznej warstwie pęcherzyka żółciowego lub dróg żółciowych (błona śluzowa), mają najkorzystniejsze rokowanie. Guzy, które rozprzestrzeniły się przez ściany pęcherzyka żółciowego lub dróg żółciowych do pobliskich węzłów chłonnych lub narządów, mają gorsze rokowanie.¹⁸

Guzy, które są nadal zlokalizowane w pęcherzyku żółciowym lub drogach żółciowych, mają najkorzystniejsze rokowanie. Rokowanie jest złe, gdy guzy rozprzestrzeniły się do odległych narządów, do węzłów chłonnych lub naczyń krwionośnych (tzw. inwazja limfonaczyniowa).¹⁹

Umiejscowienie guza

Lokalizacja guza ma istotny wpływ na rokowanie. Guzy zlokalizowane dalej od wątroby zwykle mają lepsze rokowanie. Guzy w dystalnej części dróg żółciowych zazwyczaj mają lepsze rokowanie niż wewnątrzwątrobowy lub okołownękowy rak dróg żółciowych.²⁰ Jednocześnie obecność raka typu Bismuth IV (obejmującego zarówno prawe, jak i lewe wewnątrzwątrobowe drogi żółciowe) nie jest już bezwzględnym przeciwwskazaniem do całkowitej resekcji, ponieważ wiąże się z całkowitym przeżyciem podobnym do tego u pacjentów z mniej rozległą dystrybucją w drogach żółciowych.²¹

Typ histologiczny nowotworu

Typ histologiczny nowotworu ma wpływ na rokowanie. Brodawkowaty rak pęcherzyka żółciowego zwykle ma lepsze rokowanie niż inne nowotwory dróg żółciowych.²² Brodawkowate raki dróg żółciowych mają bardziej korzystne rokowanie niż klasyczne niepapilarne gruczolakoraki, z 5-letnim wskaźnikiem przeżycia odpowiednio 22% wobec 8%.²³

Warianty płaskonabłonkowe i wrzecionowatokomórkowe wydają się mieć gorsze rokowanie niż klasyczne gruczolakoraki.²⁴ Guzy pęcherzyka żółciowego, które są bardziej zróżnicowane i wolno rosnące (niskiego stopnia), mają lepsze rokowanie niż guzy szybko rosnące (wysokiego stopnia).²⁵

Zajęcie węzłów chłonnych

Obecność przerzutów w węzłach chłonnych stanowi istotny czynnik prognostyczny w analizach jedno- i wieloczynnikowych.²⁶ Pozytywne węzły chłonne zwykle wiążą się z gorszym rokowaniem.

Inne istotne czynniki prognostyczne

Inne czynniki, które wpływają na rokowanie, obejmują:

Wiek pacjenta – młodsi pacjenci (poniżej 54 lat) mają lepsze rokowanie²⁷
Wielkość guza – mniejsze guzy wiążą się z lepszym rokowaniem²⁸
Brak inwazji naczyniowej²⁹
Zastosowanie chemioterapii u pacjentów z chorobą w stadium I-III³⁰
Obecność objawów związanych z nowotworem (takich jak ból brzucha czy ogólne złe samopoczucie) lub stopień upośledzenia czynności wątroby³¹
Ogólny stan zdrowia i sprawność fizyczna – osoby w lepszej kondycji fizycznej mogą lepiej radzić sobie z nowotworem i leczeniem³²
Status socjoekonomiczny – pacjenci płci męskiej o niskich rocznych dochodach wykazują tendencję do krótszego całkowitego przeżycia³³
Miejsce diagnozy i leczenia – pacjenci diagnozowani w ośrodkach akademickich mają lepsze wskaźniki przeżycia³⁴

Możliwość wyleczenia raka dróg żółciowych

Rak dróg żółciowych jest uleczalny we wczesnych stadiach, jeśli lekarz może chirurgicznie usunąć wszystkie dotknięte tkanki. Na tym etapie przeszczep wątroby może być również potencjalną opcją wyleczenia cholangiocarcinoma.³⁵ Jednak tylko niewielka liczba przypadków raka dróg żółciowych jest uleczalna, ponieważ nowotwory te zwykle nie są diagnozowane, dopóki rak nie zdąży się rozprzestrzenić. Na tym etapie niemożliwe jest pozbycie się cholangiocarcinoma wyłącznie za pomocą operacji.³⁶

Długoterminowe przeżycie pacjentów z wewnątrzwątrobowym rakiem dróg żółciowych (ICC) jest bardzo złe. W porównaniu z pacjentami nieoperacyjnymi, operacja zapewnia około 18% i 12% lepsze wskaźniki przeżycia całkowitego odpowiednio po 3 i 5 latach. Wczesne wykrycie i interwencja chirurgiczna mogą znacznie poprawić całkowite przeżycie u pacjentów z ICC.³⁷

Właściwa interpretacja wskaźników przeżycia

Wskaźniki przeżycia mogą dać pojęcie o tym, jaki procent osób z tym samym typem i stadium nowotworu nadal żyje przez określony czas (zwykle 5 lat) po rozpoznaniu. Informacje te nie mogą jednak przewidzieć, jak długo będziesz żyć, ale mogą pomóc lepiej zrozumieć, jak prawdopodobne jest, że twoje leczenie będzie skuteczne.³⁸

Należy pamiętać, że wskaźniki przeżycia są szacunkowe i często opierają się na wcześniejszych wynikach dużej liczby osób, które miały określony nowotwór, ale nie mogą przewidzieć, co stanie się w konkretnym przypadku.³⁹ Te statystyki mogą być mylące i mogą prowadzić do większej liczby pytań. Warto zapytać zespół onkologiczny, jak te liczby mogą odnosić się do indywidualnego przypadku.⁴⁰

Względny wskaźnik przeżycia porównuje osoby z tym samym typem i stadium nowotworu z osobami w ogólnej populacji. Na przykład, jeśli 5-letni względny wskaźnik przeżycia dla określonego stadium raka dróg żółciowych (cholangiocarcinoma) wynosi 30%, oznacza to, że osoby, które mają ten nowotwór, mają średnio około 30% szans na przeżycie co najmniej 5 lat po zdiagnozowaniu w porównaniu z osobami, które nie mają tego nowotworu.⁴¹

Te liczby odnoszą się tylko do stadium nowotworu w momencie pierwszej diagnozy. Nie mają zastosowania później, jeśli nowotwór rośnie, rozprzestrzenia się lub nawraca po leczeniu.⁴² Ponadto, te liczby nie uwzględniają wszystkiego. Wskaźniki przeżycia są grupowane na podstawie tego, jak daleko rozprzestrzenił się nowotwór. Ale inne czynniki, takie jak wiek, ogólny stan zdrowia i to, jak dobrze nowotwór reaguje na leczenie, również mogą wpływać na rokowanie.⁴³

Nowe perspektywy w leczeniu i rokowaniu

Osoby obecnie diagnozowane z rakiem dróg żółciowych mogą mieć lepsze rokowanie niż wskazują te liczby. Metody leczenia ulegają poprawie z czasem, a te liczby opierają się na osobach, które zostały zdiagnozowane i leczone co najmniej pięć lat wcześniej.⁴⁴

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.⁴⁵

Znane czynniki ryzyka raka dróg żółciowych są zaangażowane tylko w 20% przypadków, co wskazuje na pilną potrzebę ustalenia innych przyczyn choroby w celu zwiększenia świadomości i polityki badań przesiewowych dla wczesnej diagnozy, co może znacząco wpłynąć na wyniki leczenia pacjentów.⁴⁶

Zarządzanie rakiem dróg żółciowych wymaga obecnie specjalistycznych ośrodków z multidyscyplinarną ekspertyzą, które umożliwiają właściwe przeniesienie podstawowych badań do praktyki klinicznej. Przyszłe badania powinny skupić się na poprawie wskaźników przeżycia i zmniejszeniu częstości nawrotów nowotworów po resekcji, które są nadal niezadowalające (5-letnie przeżycie 7-20%).⁴⁷

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Materiały źródłowe

#1 Cholangiocarcinoma (Bile Duct Cancer)
https://my.clevelandclinic.org/health/diseases/21524-cholangiocarcinoma
Cholangiocarcinoma is an aggressive cancer, which means it spreads fast. Most people receive a cholangiocarcinoma diagnosis after its already spread outside of their bile ducts. At this point, bile duct cancer is difficult to treat, and the prognosis (chance of recovery) is usually poor. […] The outlook (prognosis) for people with cholangiocarcinoma is usually poor. […] The five-year survival rate for cholangiocarcinoma that hasnt spread outside of the bile ducts ranges from 18% to 23%. That number drops to 2% to 3% for cancer thats spread beyond bile ducts. […] Still, its important to remember that new cancer treatments are continually improving survival rates and the experiences of people living with cancer. Five-year survival rates reporting on statistics from previous years dont reflect these developments.
#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. […] 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.
#3 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. […] 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.
#4 Cholangiocarcinoma (Bile Duct Cancer)
https://my.clevelandclinic.org/health/diseases/21524-cholangiocarcinoma
Cholangiocarcinoma is an aggressive cancer, which means it spreads fast. Most people receive a cholangiocarcinoma diagnosis after its already spread outside of their bile ducts. At this point, bile duct cancer is difficult to treat, and the prognosis (chance of recovery) is usually poor. […] The outlook (prognosis) for people with cholangiocarcinoma is usually poor. […] The five-year survival rate for cholangiocarcinoma that hasnt spread outside of the bile ducts ranges from 18% to 23%. That number drops to 2% to 3% for cancer thats spread beyond bile ducts. […] Still, its important to remember that new cancer treatments are continually improving survival rates and the experiences of people living with cancer. Five-year survival rates reporting on statistics from previous years dont reflect these developments.
#5 Cholangiocarcinoma (Bile Duct Cancer)
https://my.clevelandclinic.org/health/diseases/21524-cholangiocarcinoma
Cholangiocarcinoma is an aggressive cancer, which means it spreads fast. Most people receive a cholangiocarcinoma diagnosis after its already spread outside of their bile ducts. At this point, bile duct cancer is difficult to treat, and the prognosis (chance of recovery) is usually poor. […] The outlook (prognosis) for people with cholangiocarcinoma is usually poor. […] The five-year survival rate for cholangiocarcinoma that hasnt spread outside of the bile ducts ranges from 18% to 23%. That number drops to 2% to 3% for cancer thats spread beyond bile ducts. […] Still, its important to remember that new cancer treatments are continually improving survival rates and the experiences of people living with cancer. Five-year survival rates reporting on statistics from previous years dont reflect these developments.
#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
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. […] 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. […] These numbers donât take everything into account. Survival rates are grouped based on how far the cancer has spread. But other factors such as your age, your overall health, and how well the cancer responds to treatment, can also affect your outlook. […] 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.
#7 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.
#8 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.
#9 Survival for bile duct cancer | Cancer Research UK
https://www.cancerresearchuk.org/about-cancer/bile-duct-cancer/survival
Survival depends on different factors. So no one can tell you exactly how long you will live. […] Doctors usually work out the outlook for a certain disease by looking at large groups of people. Because this cancer is less common, survival is harder to estimate than for other, more common cancers. […] Your outlook depends on the stage of the cancer when it was diagnosed. This means how big it is and whether it has spread. […] Almost 25 out of 100 people (almost 25%) survive their cancer for 5 years or more after they are diagnosed. […] Around 10 out of 100 people (around 10%) survive their cancer for 5 years or more after they are diagnosed. […] Almost 5 out of 100 people (almost 5%) survive their cancer for 5 years or more after they are diagnosed. […] Almost 20 out of 100 people (almost 20%) survive their cancer for 5 years or more after they are diagnosed.
#10 Survival for bile duct cancer | Cancer Research UK
https://www.cancerresearchuk.org/about-cancer/bile-duct-cancer/survival
Almost 20 out of 100 people (almost 20%) survive their cancer for 5 years or more after they are diagnosed. […] Only 2 out of 100 people (only 2%) survive their cancer for 5 years or more after they are diagnosed. […] Almost 30 out of 100 people (almost 30%) survived their cancer for 1 year or more after they were diagnosed. […] 5 out of 100 people (5%) survived their cancer for 5 years or more after they were diagnosed. […] Your general health and fitness also affect survival. This is because the fitter you are, the better you may be able to cope with your cancer and treatment.
#11 Nationwide treatment and outcomes of perihilar cholangiocarcinoma
https://pmc.ncbi.nlm.nih.gov/articles/PMC8359996/
A total of 2031 patients were included and the median overall survival for the overall cohort was 5.2 (95% CI 4.75.7) months. […] Median overall survival was 5.2 (95%CI 4.75.7) months, with 1, 3 and 5-year survival rates of 31%, 10% and 6% respectively. Overall survival was dependent on age, gender, the presence of metastases, treatment and socioeconomic status. […] In patients with pCCA, resection rate and overall survival were higher for patients who were diagnosed in academic centres. […] Median overall survival was 9.7 (95% CI 7.711.7) months in academic centres compared to 4.9 (95% CI 4.35.4) months in nonacademic centres (P .001). […] 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.
#12 Prognosis and survival for biliary tract cancers | Canadian Cancer Society
https://cancer.ca/en/cancer-information/cancer-types/biliary-tract/prognosis-and-survival
A prognosis is the doctor’s best estimate of how cancer will affect you and how it will respond to treatment. Survival is the percentage of people with a disease who are alive at some point in time after their diagnosis. Prognosis and survival depend on many factors. […] The following are prognostic and predictive factors for biliary tract cancers. […] Surgery is the most effective treatment for biliary tract cancers. This means that the most important prognostic factor for biliary tract cancers is whether a tumour can be removed completely through with surgery (called resectability). Tumours that can be completely removed with surgery (resectable) have a much more favourable prognosis than tumours that cannot be removed by surgery (unresectable). Early-stage cancers, smaller tumours, or those that have not spread to other organs or tissues are most likely to be resectable.
#13 Prognosis and survival for biliary tract cancers | Canadian Cancer Society
https://cancer.ca/en/cancer-information/cancer-types/biliary-tract/prognosis-and-survival
A prognosis is the doctor’s best estimate of how cancer will affect you and how it will respond to treatment. Survival is the percentage of people with a disease who are alive at some point in time after their diagnosis. Prognosis and survival depend on many factors. […] The following are prognostic and predictive factors for biliary tract cancers. […] Surgery is the most effective treatment for biliary tract cancers. This means that the most important prognostic factor for biliary tract cancers is whether a tumour can be removed completely through with surgery (called resectability). Tumours that can be completely removed with surgery (resectable) have a much more favourable prognosis than tumours that cannot be removed by surgery (unresectable). Early-stage cancers, smaller tumours, or those that have not spread to other organs or tissues are most likely to be resectable.
#14 Pathological aspects of cholangiocarcinoma
https://pmc.ncbi.nlm.nih.gov/articles/PMC2504382/
Biliary papillary carcinomas have a more favorable prognosis than classical non-papillary adenocarcinomas, with a 5-year survival rate of 22% versus 8%, respectively. […] These factors have been associated with a worse prognosis of bile duct cancer, mostly at univariate analysis, in different surgical series. […] Positive lymph nodes usually represent a prognostic relevant factor in uni- and multivariate analyses. […] Obtaining negative margins (R0) at resection represents an important prognostic factor in all subgroups of CC, as shown in all large surgical series. […] Some studies have suggested that only invasive carcinoma and not carcinoma in situ at the bile duct resection margin significantly affects the survival of patients with hilar and/or distal ECC. […] The relevance of the radial margin status in extrahepatic CC has been underscored by others. […] Since a curative resection is one of the most robust prognostic factors for CC, larger studies are surely needed to obtain an international consensus for the pathological examination of surgical specimens with CC.
#15 Pathological aspects of cholangiocarcinoma
https://pmc.ncbi.nlm.nih.gov/articles/PMC2504382/
Biliary papillary carcinomas have a more favorable prognosis than classical non-papillary adenocarcinomas, with a 5-year survival rate of 22% versus 8%, respectively. […] These factors have been associated with a worse prognosis of bile duct cancer, mostly at univariate analysis, in different surgical series. […] Positive lymph nodes usually represent a prognostic relevant factor in uni- and multivariate analyses. […] Obtaining negative margins (R0) at resection represents an important prognostic factor in all subgroups of CC, as shown in all large surgical series. […] Some studies have suggested that only invasive carcinoma and not carcinoma in situ at the bile duct resection margin significantly affects the survival of patients with hilar and/or distal ECC. […] The relevance of the radial margin status in extrahepatic CC has been underscored by others. […] Since a curative resection is one of the most robust prognostic factors for CC, larger studies are surely needed to obtain an international consensus for the pathological examination of surgical specimens with CC.
#16 Pathological aspects of cholangiocarcinoma
https://pmc.ncbi.nlm.nih.gov/articles/PMC2504382/
Biliary papillary carcinomas have a more favorable prognosis than classical non-papillary adenocarcinomas, with a 5-year survival rate of 22% versus 8%, respectively. […] These factors have been associated with a worse prognosis of bile duct cancer, mostly at univariate analysis, in different surgical series. […] Positive lymph nodes usually represent a prognostic relevant factor in uni- and multivariate analyses. […] Obtaining negative margins (R0) at resection represents an important prognostic factor in all subgroups of CC, as shown in all large surgical series. […] Some studies have suggested that only invasive carcinoma and not carcinoma in situ at the bile duct resection margin significantly affects the survival of patients with hilar and/or distal ECC. […] The relevance of the radial margin status in extrahepatic CC has been underscored by others. […] Since a curative resection is one of the most robust prognostic factors for CC, larger studies are surely needed to obtain an international consensus for the pathological examination of surgical specimens with CC.
#17 Nationwide treatment and outcomes of perihilar cholangiocarcinoma
https://pmc.ncbi.nlm.nih.gov/articles/PMC8359996/
The 32% resection rate in patients first diagnosed in academic centres is similar to previously published resection rates in series from experienced centres that range from 30% to 34%. […] The overall resection rate of 15% is lower than usually reported, however, no other nationwide series including all patients are currently available for comparison. […] The high mortality after resection, especially in elderly patients is in line with previous literature. […] Despite an increase in resection rate over the study years, the difference in resection rate remains substantial between patients diagnosed in academic and nonacademic centres.
#18 Prognosis and survival for biliary tract cancers | Canadian Cancer Society
https://cancer.ca/en/cancer-information/cancer-types/biliary-tract/prognosis-and-survival
People with early-stage biliary tract cancers have a better prognosis than those with advanced biliary tract cancers. Tumours that are still in the innermost layer of the gallbladder or bile duct (the mucosa) have the most favourable prognosis. Tumours that have spread through the gallbladder or bile duct walls and into nearby lymph nodes or organs have a worse prognosis. […] Tumours that are still localized to the gallbladder or bile duct have the most favourable prognosis. Prognosis is poor when tumours have spread to distant organs or into lymph nodes or blood vessels (called lymphovascular invasion). […] Gallbladder tumours that are more differentiated and slow growing (low-grade) have a better prognosis than tumours that are fast-growing (high-grade). […] Tumours that are located farther from the liver typically have a better prognosis. Tumours in the distal part of the bile ducts usually have a better prognosis than intrahepatic or perihilar cholangiocarcinoma. […] Papillary gallbladder adenocarcinoma usually has a better prognosis than other biliary tract cancers.
#19 Prognosis and survival for biliary tract cancers | Canadian Cancer Society
https://cancer.ca/en/cancer-information/cancer-types/biliary-tract/prognosis-and-survival
People with early-stage biliary tract cancers have a better prognosis than those with advanced biliary tract cancers. Tumours that are still in the innermost layer of the gallbladder or bile duct (the mucosa) have the most favourable prognosis. Tumours that have spread through the gallbladder or bile duct walls and into nearby lymph nodes or organs have a worse prognosis. […] Tumours that are still localized to the gallbladder or bile duct have the most favourable prognosis. Prognosis is poor when tumours have spread to distant organs or into lymph nodes or blood vessels (called lymphovascular invasion). […] Gallbladder tumours that are more differentiated and slow growing (low-grade) have a better prognosis than tumours that are fast-growing (high-grade). […] Tumours that are located farther from the liver typically have a better prognosis. Tumours in the distal part of the bile ducts usually have a better prognosis than intrahepatic or perihilar cholangiocarcinoma. […] Papillary gallbladder adenocarcinoma usually has a better prognosis than other biliary tract cancers.
#20 Prognosis and survival for biliary tract cancers | Canadian Cancer Society
https://cancer.ca/en/cancer-information/cancer-types/biliary-tract/prognosis-and-survival
People with early-stage biliary tract cancers have a better prognosis than those with advanced biliary tract cancers. Tumours that are still in the innermost layer of the gallbladder or bile duct (the mucosa) have the most favourable prognosis. Tumours that have spread through the gallbladder or bile duct walls and into nearby lymph nodes or organs have a worse prognosis. […] Tumours that are still localized to the gallbladder or bile duct have the most favourable prognosis. Prognosis is poor when tumours have spread to distant organs or into lymph nodes or blood vessels (called lymphovascular invasion). […] Gallbladder tumours that are more differentiated and slow growing (low-grade) have a better prognosis than tumours that are fast-growing (high-grade). […] Tumours that are located farther from the liver typically have a better prognosis. Tumours in the distal part of the bile ducts usually have a better prognosis than intrahepatic or perihilar cholangiocarcinoma. […] Papillary gallbladder adenocarcinoma usually has a better prognosis than other biliary tract cancers.
#21 Cholangiocarcinoma 2020: the next horizon in mechanisms and management | Nature Reviews Gastroenterology & Hepatology
https://www.nature.com/articles/s41575-020-0310-z
The three subtypes of CCA can have different risk factors, pathobiology, clinical presentations, management and prognosis, as well as distinct epidemiological trends. […] Of note, the hospital charges associated with iCCA management almost doubled from 2005 to 2014 in the USA, and male patients with low annual incomes tended to show shorter overall survival, pinpointing socioeconomic treatment discrepancies that clearly affect outcome. […] 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 overall survival 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 degrees is associated with a poor prognosis.
#22 Prognosis and survival for biliary tract cancers | Canadian Cancer Society
https://cancer.ca/en/cancer-information/cancer-types/biliary-tract/prognosis-and-survival
People with early-stage biliary tract cancers have a better prognosis than those with advanced biliary tract cancers. Tumours that are still in the innermost layer of the gallbladder or bile duct (the mucosa) have the most favourable prognosis. Tumours that have spread through the gallbladder or bile duct walls and into nearby lymph nodes or organs have a worse prognosis. […] Tumours that are still localized to the gallbladder or bile duct have the most favourable prognosis. Prognosis is poor when tumours have spread to distant organs or into lymph nodes or blood vessels (called lymphovascular invasion). […] Gallbladder tumours that are more differentiated and slow growing (low-grade) have a better prognosis than tumours that are fast-growing (high-grade). […] Tumours that are located farther from the liver typically have a better prognosis. Tumours in the distal part of the bile ducts usually have a better prognosis than intrahepatic or perihilar cholangiocarcinoma. […] Papillary gallbladder adenocarcinoma usually has a better prognosis than other biliary tract cancers.
#23 Pathological aspects of cholangiocarcinoma
https://pmc.ncbi.nlm.nih.gov/articles/PMC2504382/
Biliary papillary carcinomas have a more favorable prognosis than classical non-papillary adenocarcinomas, with a 5-year survival rate of 22% versus 8%, respectively. […] These factors have been associated with a worse prognosis of bile duct cancer, mostly at univariate analysis, in different surgical series. […] Positive lymph nodes usually represent a prognostic relevant factor in uni- and multivariate analyses. […] Obtaining negative margins (R0) at resection represents an important prognostic factor in all subgroups of CC, as shown in all large surgical series. […] Some studies have suggested that only invasive carcinoma and not carcinoma in situ at the bile duct resection margin significantly affects the survival of patients with hilar and/or distal ECC. […] The relevance of the radial margin status in extrahepatic CC has been underscored by others. […] Since a curative resection is one of the most robust prognostic factors for CC, larger studies are surely needed to obtain an international consensus for the pathological examination of surgical specimens with CC.
#24 Pathological aspects of cholangiocarcinoma
https://pmc.ncbi.nlm.nih.gov/articles/PMC2504382/
Cholangiocarcinoma (CC) arises from the biliary epithelium and in most cases represents adenocarcinoma. Pathomorphological evaluation is of decisive impact for the prognosis and management of CC. Morphological subtyping (histotype; hilar vs peripheral type), TNM classification, lymphatic spread, and resection margin status are of prognostic relevance. […] Bile duct cancer (cholangiocarcinoma (CC)) accounts for about 3% of all gastrointestinal cancers with a dismal long-term survival of 3.5%. […] According to this classification, perhilar tumors occur most frequently, followed in order by the extrahepatic distal and intrahepatic types. […] Both hilar and peripheral ICC have been related to different premalignant conditions, progression features, and prognoses. […] The adenosquamous and spindle cell variants appear to have a worse prognosis than classical adenocarcinomas.
#25 Prognosis and survival for biliary tract cancers | Canadian Cancer Society
https://cancer.ca/en/cancer-information/cancer-types/biliary-tract/prognosis-and-survival
People with early-stage biliary tract cancers have a better prognosis than those with advanced biliary tract cancers. Tumours that are still in the innermost layer of the gallbladder or bile duct (the mucosa) have the most favourable prognosis. Tumours that have spread through the gallbladder or bile duct walls and into nearby lymph nodes or organs have a worse prognosis. […] Tumours that are still localized to the gallbladder or bile duct have the most favourable prognosis. Prognosis is poor when tumours have spread to distant organs or into lymph nodes or blood vessels (called lymphovascular invasion). […] Gallbladder tumours that are more differentiated and slow growing (low-grade) have a better prognosis than tumours that are fast-growing (high-grade). […] Tumours that are located farther from the liver typically have a better prognosis. Tumours in the distal part of the bile ducts usually have a better prognosis than intrahepatic or perihilar cholangiocarcinoma. […] Papillary gallbladder adenocarcinoma usually has a better prognosis than other biliary tract cancers.
#26 Pathological aspects of cholangiocarcinoma
https://pmc.ncbi.nlm.nih.gov/articles/PMC2504382/
Biliary papillary carcinomas have a more favorable prognosis than classical non-papillary adenocarcinomas, with a 5-year survival rate of 22% versus 8%, respectively. […] These factors have been associated with a worse prognosis of bile duct cancer, mostly at univariate analysis, in different surgical series. […] Positive lymph nodes usually represent a prognostic relevant factor in uni- and multivariate analyses. […] Obtaining negative margins (R0) at resection represents an important prognostic factor in all subgroups of CC, as shown in all large surgical series. […] Some studies have suggested that only invasive carcinoma and not carcinoma in situ at the bile duct resection margin significantly affects the survival of patients with hilar and/or distal ECC. […] The relevance of the radial margin status in extrahepatic CC has been underscored by others. […] Since a curative resection is one of the most robust prognostic factors for CC, larger studies are surely needed to obtain an international consensus for the pathological examination of surgical specimens with CC.
#27 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. 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. The aim of this study was to investigate long-term survival and to identify the prognostic factors for survival in patients with ICC. Long-term outcomes for patients with ICC were poor as observed in the current study. 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. The use of chemotherapy for patients with stage IV did not have significant improvement of OS and CSS. The long-term survival of patients with ICC is very poor. Even in the surgery group (all stages), the 5- and 8-year OS rates for patients with ICC were only 36.4% and 32.5%, respectively. Prognostic factors included age, surgery, primary tumor size, multiple tumors, vascular invasion, and negative surgical margin. Chemotherapy was associated with improved survival in patients with stages I-III disease, but not with stage IV disease. Based on the fact of dominantly late stage and poor prognosis, early detection and appropriate treatment (surgery or chemotherapy) will increase survival in patients with ICC.
#28 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. 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. The aim of this study was to investigate long-term survival and to identify the prognostic factors for survival in patients with ICC. Long-term outcomes for patients with ICC were poor as observed in the current study. 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. The use of chemotherapy for patients with stage IV did not have significant improvement of OS and CSS. The long-term survival of patients with ICC is very poor. Even in the surgery group (all stages), the 5- and 8-year OS rates for patients with ICC were only 36.4% and 32.5%, respectively. Prognostic factors included age, surgery, primary tumor size, multiple tumors, vascular invasion, and negative surgical margin. Chemotherapy was associated with improved survival in patients with stages I-III disease, but not with stage IV disease. Based on the fact of dominantly late stage and poor prognosis, early detection and appropriate treatment (surgery or chemotherapy) will increase survival in patients with ICC.
#29 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. 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. The aim of this study was to investigate long-term survival and to identify the prognostic factors for survival in patients with ICC. Long-term outcomes for patients with ICC were poor as observed in the current study. 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. The use of chemotherapy for patients with stage IV did not have significant improvement of OS and CSS. The long-term survival of patients with ICC is very poor. Even in the surgery group (all stages), the 5- and 8-year OS rates for patients with ICC were only 36.4% and 32.5%, respectively. Prognostic factors included age, surgery, primary tumor size, multiple tumors, vascular invasion, and negative surgical margin. Chemotherapy was associated with improved survival in patients with stages I-III disease, but not with stage IV disease. Based on the fact of dominantly late stage and poor prognosis, early detection and appropriate treatment (surgery or chemotherapy) will increase survival in patients with ICC.
#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. 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. The aim of this study was to investigate long-term survival and to identify the prognostic factors for survival in patients with ICC. Long-term outcomes for patients with ICC were poor as observed in the current study. 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. The use of chemotherapy for patients with stage IV did not have significant improvement of OS and CSS. The long-term survival of patients with ICC is very poor. Even in the surgery group (all stages), the 5- and 8-year OS rates for patients with ICC were only 36.4% and 32.5%, respectively. Prognostic factors included age, surgery, primary tumor size, multiple tumors, vascular invasion, and negative surgical margin. Chemotherapy was associated with improved survival in patients with stages I-III disease, but not with stage IV disease. Based on the fact of dominantly late stage and poor prognosis, early detection and appropriate treatment (surgery or chemotherapy) will increase survival 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
The presence of cancer-related symptoms (such as abdominal pain or malaise) or the degree of liver function impairment are relevant prognostic factors that should be considered in future versions of the AJCC TNM classifications. […] 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. […] 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. […] CCAs are highly aggressive and heterogeneous, at both the intertumoural and intratumoural levels, resulting in poor prognosis.
#32 Survival for bile duct cancer | Cancer Research UK
https://www.cancerresearchuk.org/about-cancer/bile-duct-cancer/survival
Almost 20 out of 100 people (almost 20%) survive their cancer for 5 years or more after they are diagnosed. […] Only 2 out of 100 people (only 2%) survive their cancer for 5 years or more after they are diagnosed. […] Almost 30 out of 100 people (almost 30%) survived their cancer for 1 year or more after they were diagnosed. […] 5 out of 100 people (5%) survived their cancer for 5 years or more after they were diagnosed. […] Your general health and fitness also affect survival. This is because the fitter you are, the better you may be able to cope with your cancer and treatment.
#33 Cholangiocarcinoma 2020: the next horizon in mechanisms and management | Nature Reviews Gastroenterology & Hepatology
https://www.nature.com/articles/s41575-020-0310-z
The three subtypes of CCA can have different risk factors, pathobiology, clinical presentations, management and prognosis, as well as distinct epidemiological trends. […] Of note, the hospital charges associated with iCCA management almost doubled from 2005 to 2014 in the USA, and male patients with low annual incomes tended to show shorter overall survival, pinpointing socioeconomic treatment discrepancies that clearly affect outcome. […] 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 overall survival 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 degrees is associated with a poor prognosis.
#34 Nationwide treatment and outcomes of perihilar cholangiocarcinoma
https://pmc.ncbi.nlm.nih.gov/articles/PMC8359996/
A total of 2031 patients were included and the median overall survival for the overall cohort was 5.2 (95% CI 4.75.7) months. […] Median overall survival was 5.2 (95%CI 4.75.7) months, with 1, 3 and 5-year survival rates of 31%, 10% and 6% respectively. Overall survival was dependent on age, gender, the presence of metastases, treatment and socioeconomic status. […] In patients with pCCA, resection rate and overall survival were higher for patients who were diagnosed in academic centres. […] Median overall survival was 9.7 (95% CI 7.711.7) months in academic centres compared to 4.9 (95% CI 4.35.4) months in nonacademic centres (P .001). […] 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.
#35 Cholangiocarcinoma (Bile Duct Cancer)
https://my.clevelandclinic.org/health/diseases/21524-cholangiocarcinoma
Bile duct cancer is curable in the early stages if your provider can surgically remove all affected tissue. At this point, a liver transplant may also be a potential option for curing cholangiocarcinoma. […] But only a small amount of bile duct cancers are curable because theyre usually not diagnosed until the cancer has already spread. At this point, its impossible to get rid of cholangiocarcinoma with surgery alone.
#36 Cholangiocarcinoma (Bile Duct Cancer)
https://my.clevelandclinic.org/health/diseases/21524-cholangiocarcinoma
Bile duct cancer is curable in the early stages if your provider can surgically remove all affected tissue. At this point, a liver transplant may also be a potential option for curing cholangiocarcinoma. […] But only a small amount of bile duct cancers are curable because theyre usually not diagnosed until the cancer has already spread. At this point, its impossible to get rid of cholangiocarcinoma with surgery alone.
#37 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. 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. The aim of this study was to investigate long-term survival and to identify the prognostic factors for survival in patients with ICC. Long-term outcomes for patients with ICC were poor as observed in the current study. 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. The use of chemotherapy for patients with stage IV did not have significant improvement of OS and CSS. The long-term survival of patients with ICC is very poor. Even in the surgery group (all stages), the 5- and 8-year OS rates for patients with ICC were only 36.4% and 32.5%, respectively. Prognostic factors included age, surgery, primary tumor size, multiple tumors, vascular invasion, and negative surgical margin. Chemotherapy was associated with improved survival in patients with stages I-III disease, but not with stage IV disease. Based on the fact of dominantly late stage and poor prognosis, early detection and appropriate treatment (surgery or chemotherapy) will increase survival in patients with ICC.
#38 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. […] These statistics can be confusing and may lead you to have more questions. Ask your cancer care team how these numbers might apply to you. […] A relative survival rate compares people with the same type and stage of cancer to people in the overall population.
#39 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. […] These statistics can be confusing and may lead you to have more questions. Ask your cancer care team how these numbers might apply to you. […] A relative survival rate compares people with the same type and stage of cancer to people in the overall population.
#40 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. […] These statistics can be confusing and may lead you to have more questions. Ask your cancer care team how these numbers might apply to you. […] A relative survival rate compares people with the same type and stage of cancer to people in the overall population.
#41 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
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. […] 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. […] These numbers donât take everything into account. Survival rates are grouped based on how far the cancer has spread. But other factors such as your age, your overall health, and how well the cancer responds to treatment, can also affect your outlook. […] 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.
#42 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
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. […] 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. […] These numbers donât take everything into account. Survival rates are grouped based on how far the cancer has spread. But other factors such as your age, your overall health, and how well the cancer responds to treatment, can also affect your outlook. […] 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.
#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
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. […] 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. […] These numbers donât take everything into account. Survival rates are grouped based on how far the cancer has spread. But other factors such as your age, your overall health, and how well the cancer responds to treatment, can also affect your outlook. […] 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
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. […] 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. […] These numbers donât take everything into account. Survival rates are grouped based on how far the cancer has spread. But other factors such as your age, your overall health, and how well the cancer responds to treatment, can also affect your outlook. […] 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 Cholangiocarcinoma 2020: the next horizon in mechanisms and management | Nature Reviews Gastroenterology & Hepatology
https://www.nature.com/articles/s41575-020-0310-z
The presence of cancer-related symptoms (such as abdominal pain or malaise) or the degree of liver function impairment are relevant prognostic factors that should be considered in future versions of the AJCC TNM classifications. […] 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. […] 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. […] CCAs are highly aggressive and heterogeneous, at both the intertumoural and intratumoural levels, resulting in poor prognosis.
#46 Cholangiocarcinoma 2020: the next horizon in mechanisms and management | Nature Reviews Gastroenterology & Hepatology
https://www.nature.com/articles/s41575-020-0310-z
The presence of cancer-related symptoms (such as abdominal pain or malaise) or the degree of liver function impairment are relevant prognostic factors that should be considered in future versions of the AJCC TNM classifications. […] 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. […] 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. […] CCAs are highly aggressive and heterogeneous, at both the intertumoural and intratumoural levels, resulting in poor prognosis.
#47 Cholangiocarcinoma 2020: the next horizon in mechanisms and management | Nature Reviews Gastroenterology & Hepatology
https://www.nature.com/articles/s41575-020-0310-z
The presence of cancer-related symptoms (such as abdominal pain or malaise) or the degree of liver function impairment are relevant prognostic factors that should be considered in future versions of the AJCC TNM classifications. […] 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. […] 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. […] CCAs are highly aggressive and heterogeneous, at both the intertumoural and intratumoural levels, resulting in poor prognosis.