Mukkamalla SKR, et al. - Incidence patterns of cholangiocarcinoma (CCA) from 1973 through 2012 in the United States, along with the demographic, clinical, and treatment variables affecting CCA survival were investigated for the first time till date. Across different races, sexes, and ethnicities, temporal patterns of increasing incidence of CCA were demonstrated. This investigation represents the most up-to-date study of CCA from the SEER registry. In patients with CCA, independent prognostic factors for overall survival (OS) included age, sex, race, marital status, income, smoking status, anatomic location of CCA, tumor grade, tumor stage, radiation, and surgery.

• Researchers used SEER*Stat software and SEER database to assess age-adjusted incidence rates from 1973–2012.
• For survival analysis, they identified a retrospective cohort of 26,994 patients diagnosed with CCA from 1973–2008.
• They used Cox proportional hazards models to perform multivariate survival analysis.

• From 1973–2012, overall incidence of CCA increased by 65%.
• Relative to intrahepatic CCA (ICC), extrahepatic CCA (ECC) continued to be more common, whereas the incidence rates for ICC increased by 350% compared with a 20% increase seen with ECC.
• The highest incidence rates of CCA were reported among men belonging to non–African American and non-Caucasian ethnicities.
• Findings showed persistence in this trend throughout the study period, although incidence rates among African Americans and Caucasians increased by 50% and 59%, respectively, compared with a 9% increase among other races.
• In patients with ECC vs in those with ICC, median overall survival (OS) of 8 months and 4 months was noted, respectively.
• The best 5-year survival outcome was noted in Hispanic women in survival analysis (P<.0001).
• With age, diminishing of OS was noted (P<.0001), and better survival outcomes were reported for ECC vs ICC (P<.0001).
• Better survival outcomes were observed among patients who were married, were nonsmokers, belonged to a higher income class, and underwent surgery, compared with others (P<.0001).