Distinct prognosis of biliary tract cancer according to tumor location, stage, and treatment: a population-based study

Mee Joo Kang, Jiwon Lim, Sung-Sik Han, Hyeong Min Park, Sun-Whe Kim, Woo Jin Lee, Sang Myung Woo, Tae Hyun Kim, Young-Joo Won, Sang-Jae Park, Mee Joo Kang, Jiwon Lim, Sung-Sik Han, Hyeong Min Park, Sun-Whe Kim, Woo Jin Lee, Sang Myung Woo, Tae Hyun Kim, Young-Joo Won, Sang-Jae Park

Abstract

Biliary tract cancer (BTC) has been inconsistently identified according to its location in epidemiological and clinical studies. This study retrospectively reviewed the treatment pattern and prognosis of BTC according to tumor location using the Korea Central Cancer Registry data of 97,676 patients with BTC from 2006 to 2017. The proportion of localized and regional Surveillance, Epidemiology, and End Results (SEER) stage was the highest in ampulla of Vater (AoV, 78.2%) cancer, followed by extrahepatic bile duct (BD, 68.3%), gallbladder (GB, 52.6%), and intrahepatic BD (49.5%) cancers. Overall, the "no active anti-cancer treatment" rate was the highest in intrahepatic BD (52.8%), followed by extrahepatic BD (49.5%), GB (39.6%), and AoV cancers (28.9%). The 5-year relative survival rate was the highest in AoV (48.5%), followed by GB (28.5%), extrahepatic BD (19.9%), and intrahepatic BD (10.8%) cancers, which significantly improved over time, except for intrahepatic BD cancer. In the localized and regional stage, older patients had a higher risk of receiving no active anti-cancer treatment in each tumor location after adjusting for period and sex. BTC statistics should be reported separately according to tumor location due to its distinct SEER stage distribution, treatment pattern, and prognosis. Care should be taken in elderly patients to reduce the rate of no active anti-cancer treatment.

Conflict of interest statement

The authors declare no competing interests.

© 2022. The Author(s).

Figures

Figure 1
Figure 1
Incidence of biliary tract cancer according to tumor location. (a) Crude incidence rate. (b) Age-standardized incidence rate.
Figure 2
Figure 2
Change of SEER stage distribution and treatment pattern according to tumor location. (a) SEER stage distribution according to tumor location. (b) Treatment pattern according to tumor location.
Figure 3
Figure 3
Five-year relative survival rate of biliary tract cancer according to tumor location and SEER stage.
Figure 4
Figure 4
Treatment pattern and 5-year relative survival rate of localized and regional SEER stage biliary tract cancer according to tumor location. *NT no active anti-cancer treatment, FT first course of treatment. (a) Gallbladder cancer. (b) Intrahepatic bile duct cancer. (c) Extrahepatic bile duct cancer. (d) Ampulla of Vater cancer.

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