TABLE 3.
Treatment, surveillance and follow‐up among patients who developed hepatobiliary cancer or dysplasia
| Variable | Cholangio‐carcinoma (N = 122) | High‐grade dysplasia (N = 8) | Low‐grade dysplasia (N = 51) | Gallbladder cancer (N = 21) | Hepatocellular carcinoma (N = 32) |
|---|---|---|---|---|---|
| Frequency of cancer/dysplasia | 4.1% (122/2978) | 0.3% (8/2978) | 1.7% (51/2978) | 0.7% (21/2978) | 1.1% (32/2978) |
| Symptoms a at diagnosis of CCA/dysplasia | |||||
| Yes | 84 (68.9%) | 6 (75.0%) | 2 (3.9%) | NA | NA |
| No | 31 (25.4%) | 1 (12.5%) | 2 (3.9%) | ||
| Unknown/Missing | 7 (5.7%) | 1 (12.5%) | 47 (92.2%) | ||
| Frequency of cancer/dysplasia per type of surveillance | |||||
| None | 7.7% (27/350) | 0% (0/350) | 0% (0/350) | 0.6% (2/350) | 2.9% (10/350) |
| MRI and/or US | 3.3% (63/1900) | 0.4% (8/1900) | 0.8% (16/1900) | 0.8% (15/1900) | 0.8% (16/1900) |
| Including ERCP | 4.4% (32/728) | 0% (0/728) | 4.8% (35/728) | 0.5% (4/728) | 0.8% (6/728) |
| First treatment for CCA/dysplasia | |||||
| LTx | 31 (25.4%) | 3 (37.5%) | 2 (3.9%) | NA | NA |
| Resection | 35 (28.7%) | 2 (25.0%) | 1 (2.0%) | ||
| Chemotherapy | 23 (18.9%) | 0 | 0 | ||
| LTx and neoadjuvant brachy‐chemotherapy | 1 (0.8%) | 0 | 0 | ||
| Other | 5 (4.1%) | 1 (12.5%) | 1 (2.0%) | ||
| Best supportive care | 17 (13.9%) | 0 | 0 | ||
| Unknown/missing | 10 (8.2%) | 2 (25.0%) | 47 (92.2%) | ||
| Follow‐up b (years) | |||||
| Mean (SD) | 1.5 (2.5) | 2.9 (2.9) | 4.1 (3.4) | 2.8 (2.7) | 3.1 (3.4) |
| Median (IQR) | 0.6 (0.2–1.7) | 1.5 (1.1–6.6) | 4.3 (0.6–6.7) | 2.4 (0.9–3.6) | 1.4 (0.5–5.7) |
| Range, min‐max | 0.0–17.9 | 0.2–7.4 | 0.0–10.9 | 0.0–11.4 | 0.0–13.5 |
| Categories, n (%) | |||||
| <1y | 76 (62.3%) | 1 (12.5%) | 13 (25.5%) | 7 (33.3%) | 12 (37.5%) |
| 1–<5y | 33 (27.0%) | 4 (50.0%) | 17 (33.3%) | 9 (42.9%) | 9 (28.1%) |
| 5–<10y | 10 (8.2%) | 2 (25.0%) | 19 (37.3%) | 1 (4.8%) | 7 (21.9%) |
| 10–<20y | 2 (1.6%) | 0 | 2 (3.9%) | 1 (4.8%) | 1 (3.1%) |
| Missing cancer date | 1 (0.8%) | 1 (12.5%) | 0 | 3 (14.3%) | 3 (9.4%) |
Abbreviations: CCA, cholangiocarcinoma; ERCP, endoscopic retrograde cholangiopancreatography; IQR, interquartile range; MRI, Magnetic resonance imaging; NA, Not available; SD, standard deviation; US, ultrasound.
a
Weight loss, recurrent cholangitis, jaundice, pruritus, or other suspicious PSC/cancer‐related symptom.
b
From first cancer diagnosis to death or last of follow‐up alive.