Abstract
BackgroundThe purpose of this study was to explore trends in incidence, incidence-based (IB) mortality, and survival for combined hepatocellular-cholangiocarcinoma (cHCC-CC) utilizing a population-based database to attract people’s attention to this disease.MethodsThe Surveillance, Epidemiology, and End Results (SEER) database was utilized to investigate the incidence and IB mortality for cHCC-CC from 2000 to 2014. Trends in age-adjusted incidence and IB mortality were characterized by the Joinpoint Regression program. The Kaplan-Meier method and log-rank test were utilized to implement survival analyses. Cox regression was utilized to estimate independent predictors of mortality.ResultsThe incidence of cHCC-CC was 0.26 per 1,000,000 individuals in 2000 and 0.59 per 1,000,000 individuals in 2014, with an annual percent change (APC) (i.e., the extent of increase in incidence) of 3.84% (95% confidence interval [CI] 1.7–6.1; P < 0.05). The IB mortality also displayed a sustained increase (APC was 4.59%, 95% CI 1.9–7.4; P < 0.05). Compared to patients not undergoing surgery, patients undergoing surgical treatment experienced a significant increase in median survival (3 vs. 28 months; P < 0.001). However, the median survival decreased in patients with tumor size > 5 cm (20 vs. 9 months; P < 0.001). Based on univariate Cox regression analysis, African-American race, distant stage, regionalized stage, tumor size ≥ 5 cm, and no surgery were risk factors for death.ConclusionsWe identified an overall steady increase in the incidence of cHCC-CC, which indicates that primary prevention strategies for cHCC-CC have not improved much in recent years and that cHCC-CC needs to be taken seriously.
Highlights
The purpose of this study was to explore trends in incidence, incidence-based (IB) mortality, and survival for combined hepatocellular-cholangiocarcinoma utilizing a population-based database to attract people’s attention to this disease
Combined hepatocellular-cholangiocarcinoma is a distinct type of primary hepatic cancer distributed across all races in the world. Combined hepatocellularcholangiocarcinoma (cHCC-CC) was first reported by Allen in 1949 [1] and comprises ingredients of hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC) [2]
The vast majority of patients are in localized disease (n = 256; 39.9%), All patient with cHCC-CC identified using International Classification of Disease (ICD) oncology code:8180 from 2000-2014 (n=645)
Summary
The purpose of this study was to explore trends in incidence, incidence-based (IB) mortality, and survival for combined hepatocellular-cholangiocarcinoma (cHCC-CC) utilizing a population-based database to attract people’s attention to this disease. Combined hepatocellular-cholangiocarcinoma (cHCC-CC) is a distinct type of primary hepatic cancer distributed across all races in the world. CHCC-CC was first reported by Allen in 1949 [1] and comprises ingredients of hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC) [2]. Preoperative diagnosis of cHCC-CC is hard because of its particular imaging characteristics with similar features of HCC and ICC [7]. Wang et al World Journal of Surgical Oncology (2019) 17:43 have indicated that cHCC-CC are often misdiagnosed as either HCC or ICC [8, 9]. Portolani N showed that accuracy of cHCC-CC diagnosis in preoperative percutaneous liver biopsy is 11.1%, and the remaining cases are misdiagnosed as metastatic carcinoma, HCC, or ICC [10]. Treatment of cHCC-CC mainly includes hepatic resection, liver transplantation (LT), transarterial chemoembolization (TACE), radiofrequency ablation (RAF), and percutaneous ethanol injection
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