A SEER-based multi-ethnic picture of advanced intrahepatic cholangiocarcinoma in the United States pre- and post-the advent of gemcitabine/cisplatin

Research output: Contribution to journalArticle

Abstract

Background: Cholangiocarcinoma (CCA) is a rare, lethal cancer with 5-year survival of less than 10%. Although incidence rates have been increasing in the United States, ethnic variations in survival have not been investigated. We examined multi-ethnic variation in overall survival (OS) and CCA-specific survival (CSS) using data from the population-based Surveillance Epidemiology and End Results (SEER) program in the 4-year period after introduction of gemcitabine/cisplatin (GC) as treatment for CCA, compared with prior years. Methods: The study included data from 5,616 advanced, intrahepatic CCA cases reported in SEER between 1990 and 2013. Multivariable-adjusted hazard ratios (HR) and 95% confidence intervals (CIs) were calculated to examine OS and CSS by ethnicity, age, gender and in the pre- and post-GC era (1990–2000, 2001–2009 vs. 2010–2013). Results: Compared to non-Hispanic Whites, Hispanics had poorer 3-year OS (HR 1.11, 95% CI: 1.03–1.20) and 3-year CSS (HR 1.15, 95% CI: 1.05–1.25). Similarly, non-Hispanic Blacks had 3-year OS (HR 1.21, 95% CI: 1.10–1.34) and 3-year CSS (HR 1.21, 95% CI: 1.09–1.35). Males and older patients had shorter survival compared to females and younger patients. OS and CSS were both improved for patients’ post-advent of GC. Statistically significant improvement in CSS pre- and post-advent of GC was noted in non-Hispanic Whites, while Hispanics actually had worsened survival. Conclusions: Hispanics and non-Hispanic Blacks have worse survival after diagnosis with advanced, intrahepatic CCA. Further studies are needed to determine determinants of poor survival among these groups.

Original languageEnglish (US)
Pages (from-to)1063-1073
Number of pages11
JournalJournal of Gastrointestinal Oncology
Volume9
Issue number6
DOIs
StatePublished - Dec 1 2018

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gemcitabine
Cholangiocarcinoma
Cisplatin
Epidemiology
Survival
Confidence Intervals
Hispanic Americans

Keywords

  • Cholangiocarcinoma (CCA)
  • Cisplatin
  • Gemcitabine
  • Race
  • Surveillance Epidemiology and End Results (SEER)
  • Survival

ASJC Scopus subject areas

  • Oncology
  • Gastroenterology

Cite this

@article{8fa179f012a843be9f5053b624d255d8,
title = "A SEER-based multi-ethnic picture of advanced intrahepatic cholangiocarcinoma in the United States pre- and post-the advent of gemcitabine/cisplatin",
abstract = "Background: Cholangiocarcinoma (CCA) is a rare, lethal cancer with 5-year survival of less than 10{\%}. Although incidence rates have been increasing in the United States, ethnic variations in survival have not been investigated. We examined multi-ethnic variation in overall survival (OS) and CCA-specific survival (CSS) using data from the population-based Surveillance Epidemiology and End Results (SEER) program in the 4-year period after introduction of gemcitabine/cisplatin (GC) as treatment for CCA, compared with prior years. Methods: The study included data from 5,616 advanced, intrahepatic CCA cases reported in SEER between 1990 and 2013. Multivariable-adjusted hazard ratios (HR) and 95{\%} confidence intervals (CIs) were calculated to examine OS and CSS by ethnicity, age, gender and in the pre- and post-GC era (1990–2000, 2001–2009 vs. 2010–2013). Results: Compared to non-Hispanic Whites, Hispanics had poorer 3-year OS (HR 1.11, 95{\%} CI: 1.03–1.20) and 3-year CSS (HR 1.15, 95{\%} CI: 1.05–1.25). Similarly, non-Hispanic Blacks had 3-year OS (HR 1.21, 95{\%} CI: 1.10–1.34) and 3-year CSS (HR 1.21, 95{\%} CI: 1.09–1.35). Males and older patients had shorter survival compared to females and younger patients. OS and CSS were both improved for patients’ post-advent of GC. Statistically significant improvement in CSS pre- and post-advent of GC was noted in non-Hispanic Whites, while Hispanics actually had worsened survival. Conclusions: Hispanics and non-Hispanic Blacks have worse survival after diagnosis with advanced, intrahepatic CCA. Further studies are needed to determine determinants of poor survival among these groups.",
keywords = "Cholangiocarcinoma (CCA), Cisplatin, Gemcitabine, Race, Surveillance Epidemiology and End Results (SEER), Survival",
author = "Kabir Mody and Samuel Antwi and Hodge, {David O.} and Sikander Ailawadhi and Roberts, {Lewis Rowland} and Tanios Bekaii-Saab",
year = "2018",
month = "12",
day = "1",
doi = "10.21037/jgo.2018.07.09",
language = "English (US)",
volume = "9",
pages = "1063--1073",
journal = "Journal of Gastrointestinal Oncology",
issn = "2078-6891",
publisher = "Pioneer Bioscience Publishing Company (PBPC)",
number = "6",

}

TY - JOUR

T1 - A SEER-based multi-ethnic picture of advanced intrahepatic cholangiocarcinoma in the United States pre- and post-the advent of gemcitabine/cisplatin

AU - Mody, Kabir

AU - Antwi, Samuel

AU - Hodge, David O.

AU - Ailawadhi, Sikander

AU - Roberts, Lewis Rowland

AU - Bekaii-Saab, Tanios

PY - 2018/12/1

Y1 - 2018/12/1

N2 - Background: Cholangiocarcinoma (CCA) is a rare, lethal cancer with 5-year survival of less than 10%. Although incidence rates have been increasing in the United States, ethnic variations in survival have not been investigated. We examined multi-ethnic variation in overall survival (OS) and CCA-specific survival (CSS) using data from the population-based Surveillance Epidemiology and End Results (SEER) program in the 4-year period after introduction of gemcitabine/cisplatin (GC) as treatment for CCA, compared with prior years. Methods: The study included data from 5,616 advanced, intrahepatic CCA cases reported in SEER between 1990 and 2013. Multivariable-adjusted hazard ratios (HR) and 95% confidence intervals (CIs) were calculated to examine OS and CSS by ethnicity, age, gender and in the pre- and post-GC era (1990–2000, 2001–2009 vs. 2010–2013). Results: Compared to non-Hispanic Whites, Hispanics had poorer 3-year OS (HR 1.11, 95% CI: 1.03–1.20) and 3-year CSS (HR 1.15, 95% CI: 1.05–1.25). Similarly, non-Hispanic Blacks had 3-year OS (HR 1.21, 95% CI: 1.10–1.34) and 3-year CSS (HR 1.21, 95% CI: 1.09–1.35). Males and older patients had shorter survival compared to females and younger patients. OS and CSS were both improved for patients’ post-advent of GC. Statistically significant improvement in CSS pre- and post-advent of GC was noted in non-Hispanic Whites, while Hispanics actually had worsened survival. Conclusions: Hispanics and non-Hispanic Blacks have worse survival after diagnosis with advanced, intrahepatic CCA. Further studies are needed to determine determinants of poor survival among these groups.

AB - Background: Cholangiocarcinoma (CCA) is a rare, lethal cancer with 5-year survival of less than 10%. Although incidence rates have been increasing in the United States, ethnic variations in survival have not been investigated. We examined multi-ethnic variation in overall survival (OS) and CCA-specific survival (CSS) using data from the population-based Surveillance Epidemiology and End Results (SEER) program in the 4-year period after introduction of gemcitabine/cisplatin (GC) as treatment for CCA, compared with prior years. Methods: The study included data from 5,616 advanced, intrahepatic CCA cases reported in SEER between 1990 and 2013. Multivariable-adjusted hazard ratios (HR) and 95% confidence intervals (CIs) were calculated to examine OS and CSS by ethnicity, age, gender and in the pre- and post-GC era (1990–2000, 2001–2009 vs. 2010–2013). Results: Compared to non-Hispanic Whites, Hispanics had poorer 3-year OS (HR 1.11, 95% CI: 1.03–1.20) and 3-year CSS (HR 1.15, 95% CI: 1.05–1.25). Similarly, non-Hispanic Blacks had 3-year OS (HR 1.21, 95% CI: 1.10–1.34) and 3-year CSS (HR 1.21, 95% CI: 1.09–1.35). Males and older patients had shorter survival compared to females and younger patients. OS and CSS were both improved for patients’ post-advent of GC. Statistically significant improvement in CSS pre- and post-advent of GC was noted in non-Hispanic Whites, while Hispanics actually had worsened survival. Conclusions: Hispanics and non-Hispanic Blacks have worse survival after diagnosis with advanced, intrahepatic CCA. Further studies are needed to determine determinants of poor survival among these groups.

KW - Cholangiocarcinoma (CCA)

KW - Cisplatin

KW - Gemcitabine

KW - Race

KW - Surveillance Epidemiology and End Results (SEER)

KW - Survival

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U2 - 10.21037/jgo.2018.07.09

DO - 10.21037/jgo.2018.07.09

M3 - Article

VL - 9

SP - 1063

EP - 1073

JO - Journal of Gastrointestinal Oncology

JF - Journal of Gastrointestinal Oncology

SN - 2078-6891

IS - 6

ER -