TY - JOUR
T1 - Trends in survival after surgery for cholangiocarcinoma
T2 - A 30-Year population-based SEER database analysis
AU - Nathan, Hari
AU - Pawlik, Timothy M.
AU - Wolfgang, Christopher L.
AU - Choti, Michael A.
AU - Cameron, John L.
AU - Schulick, Richard D.
N1 - Funding Information:
Acknowledgements Dr. Nathan is supported by the Johns Hopkins-NIH Clinical Research Scholars Program (NIH K12RR017627). We are indebted to Richard E. Thompson, Ph.D., and Dorry L. Segev, M.D., for their advice on statistical analysis.
PY - 2007/11
Y1 - 2007/11
N2 - The prognosis of patients with cholangiocarcinoma historically has been poor, even after surgical resection. Although data from some single-institution series indicate improvement over historical results, survival after surgical therapy for cholangiocarcinoma has not been investigated in a population-based study. We used the Surveillance, Epidemiology, and End Results database to identify patients who underwent surgery for cholangiocarcinoma from 1973 through 2002. Multivariate modeling of survival after surgery for intrahepatic cholangiocarcinoma showed an improvement in survival only within the last decade studied, resulting in a cumulative 34.4% improvement in survival from 1992 through 2002. In contrast, multivariate modeling of survival after surgery for extrahepatic cholangiocarcinoma revealed a 23.3% increase in adjusted survival per each decade studied, resulting in a cumulative 53.7% improvement from 1973 through 2002. We conclude that survival after surgery for extrahepatic cholangiocarcinoma has dramatically improved since 1973. Patients with intrahepatic cholangiocarcinoma, however, have achieved an improvement in survival largely confined to more recent years. We suggest that these trends are largely caused by developments in imaging technology, improvements in patient selection, and advances in surgical techniques.
AB - The prognosis of patients with cholangiocarcinoma historically has been poor, even after surgical resection. Although data from some single-institution series indicate improvement over historical results, survival after surgical therapy for cholangiocarcinoma has not been investigated in a population-based study. We used the Surveillance, Epidemiology, and End Results database to identify patients who underwent surgery for cholangiocarcinoma from 1973 through 2002. Multivariate modeling of survival after surgery for intrahepatic cholangiocarcinoma showed an improvement in survival only within the last decade studied, resulting in a cumulative 34.4% improvement in survival from 1992 through 2002. In contrast, multivariate modeling of survival after surgery for extrahepatic cholangiocarcinoma revealed a 23.3% increase in adjusted survival per each decade studied, resulting in a cumulative 53.7% improvement from 1973 through 2002. We conclude that survival after surgery for extrahepatic cholangiocarcinoma has dramatically improved since 1973. Patients with intrahepatic cholangiocarcinoma, however, have achieved an improvement in survival largely confined to more recent years. We suggest that these trends are largely caused by developments in imaging technology, improvements in patient selection, and advances in surgical techniques.
KW - Biliary tract neoplasms
KW - Cholangiocarcinoma
KW - SEER
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U2 - 10.1007/s11605-007-0282-0
DO - 10.1007/s11605-007-0282-0
M3 - Article
C2 - 17805937
AN - SCOPUS:35148866287
SN - 1091-255X
VL - 11
SP - 1488
EP - 1497
JO - Journal of Gastrointestinal Surgery
JF - Journal of Gastrointestinal Surgery
IS - 11
ER -