More than 40% of patients with early stage intrahepatic cholangiocarcinoma (iCCA) are treated with noncurative therapies, according to a study published in Cancer.
The study also indicated that Black and Hispanic patients are less likely to receive curative treatment when compared with White patients.
With this study, researchers sought to describe the temporal trends of early stage iCCA in the United States. They identified patients from the National Cancer Database who were diagnosed with early stage iCCA during 2004-2018.
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There were 17,960 patients diagnosed with iCCA during the period studied, and 6.1% (n=1093) had early stage disease. The proportion of patients with early stage iCCA increased over the study period, from 4.5% in 2004 to 7.3% in 2018. The odds of early stage detection increased 3.1% per year.
“Wider implementation of liver cancer surveillance among patients with cirrhosis or chronic hepatitis B infection and advances in imaging techniques for iCCA diagnosis may, in part, explain some of the observed increases in early stage iCCA detection,” the researchers wrote.
Of the 1093 patients with early stage iCCA, 42.5% underwent resection, 10.3% underwent local ablation, and 5.7% received a liver transplant.
Noncurative treatments were given to 41.5% of patients. These 454 patients received locoregional treatment (n=122), systemic chemotherapy (n=81), and palliative/supportive care or unspecified treatment (n=251).
Receipt of curative treatment was less likely in Hispanic patients (adjusted odds ratio [aOR], 0.57; 95% CI, 0.33-0.97) and Black patients (aOR, 0.47; 95% CI, 0.28-0.77) compared with White patients. Older patients were less likely to receive curative treatment as well (aOR per 10 years, 0.60; 95% CI, 0.52-0.70).
The median overall survival was not reached in patients who received a liver transplant, 71.1 months for patients who underwent surgical resection, 48.0 months for those who underwent local ablation, and 11.7 months for those who received noncurative treatments.
“Future studies should further investigate the underlying causes of disparities in the receipt of curative treatment and validate the comparative effectiveness outcomes between different curative treatments,” the researchers wrote.
Disclosures: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.
Reference
Lee Y-T, Singal AG, Lauzon M, et al. Disparities in curative treatments and outcomes for early stage intrahepatic cholangiocarcinoma in the United States. Cancer. Published online August 23, 2022. doi:10.1002/cncr.34436
