Intrahepatic cholangiocarcinoma trends and treatment lines: real-world evidence from the French National Hospital Discharge database
Background: Little is known about the therapeutic trajectory of patients treated in hospitals for intrahepatic cholangiocarcinoma (iCCA) and patterns of care in daily clinical practice. Patients and methods: An observational retrospective study was conducted on the French National Hospital Discharge...
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Elsevier
2025-06-01
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| Series: | ESMO Gastrointestinal Oncology |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2949819825000214 |
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| author | M. Delaye B. Grenier A. Lièvre C. Neuzillet |
| author_facet | M. Delaye B. Grenier A. Lièvre C. Neuzillet |
| author_sort | M. Delaye |
| collection | DOAJ |
| description | Background: Little is known about the therapeutic trajectory of patients treated in hospitals for intrahepatic cholangiocarcinoma (iCCA) and patterns of care in daily clinical practice. Patients and methods: An observational retrospective study was conducted on the French National Hospital Discharge Database. All patients with a new diagnosis of iCCA who had a first hospital stay (S1) from January 2016 to December 2021 were included. They were followed up until December 2021, or in-hospital death, whichever occurred first. Crude annual hospitalization rates were computed. Treatment lines were identified with an artificial intelligence algorithm [Analysis of Treatment Lines using Alignment of Sequences (ATLAS)]. A multistate model was used to compute the transition rates between lines. Results: Overall, 13 491 patients were included and the mean (standard deviation) follow-up duration was 13.1 months (17.9 months). The median age at S1 was 72.0 years and 55.9% were male. Nearly 20.7% were admitted via emergency services for S1, and 32.1% had metastases. Between 2016 and 2021, the crude annual rate of new iCCA cases increased from 3.08 [95% confidence interval (CI) 2.94-3.24] in 2016 (n = 1598) to 4.12 (95% CI 3.95-4.29) per 100 000 adult person-years in 2021 (n = 2188). Among 4855 patients receiving first-line systemic therapy (L1), 37.7% (95% CI 36.0% to 39.3%) received a second-line 2 (L2) during the follow-up. The median time between the start of L1 and the beginning of L2 was 7.0 months. Conclusions: This study provides up-to-date national real-world data on iCCA, revealing an increasing burden year by year in France, a poor outcome of patients with iCCA on L1 systemic therapy, and the low proportion of patients receiving an L2. |
| format | Article |
| id | doaj-art-aa7e9a2f632b42f4b7d0cb331ea22007 |
| institution | DOAJ |
| issn | 2949-8198 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Elsevier |
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| series | ESMO Gastrointestinal Oncology |
| spelling | doaj-art-aa7e9a2f632b42f4b7d0cb331ea220072025-08-20T02:39:31ZengElsevierESMO Gastrointestinal Oncology2949-81982025-06-01810015210.1016/j.esmogo.2025.100152Intrahepatic cholangiocarcinoma trends and treatment lines: real-world evidence from the French National Hospital Discharge databaseM. Delaye0B. Grenier1A. Lièvre2C. Neuzillet3Department of Medical Oncology, Gastrointestinal Oncology, Institut Curie, Université Versailles Saint-Quentin-Université Paris-Saclay, Saint-Cloud, France; Association pour l'étude des Cancers et Affections des voies Biliaires (ACABi), Paris, France; Correspondence to: Dr Matthieu Delaye, Department of Medical Oncology, Gastrointestinal Oncology, Institut Curie, Université Versailles Saint-Quentin-Université Paris-Saclay, 35 rue, Saint-Cloud 92210, France. Tel: +33147111515Epidemiology Department, Heva, Lyon, FranceDepartment of Gastroenterology, University Hospital Pontchaillou, Rennes 1 University, INSERM U1242 “Chemistry Oncogenesis Stress Signalling”, Rennes, FranceDepartment of Medical Oncology, Gastrointestinal Oncology, Institut Curie, Université Versailles Saint-Quentin-Université Paris-Saclay, Saint-Cloud, France; Association pour l'étude des Cancers et Affections des voies Biliaires (ACABi), Paris, FranceBackground: Little is known about the therapeutic trajectory of patients treated in hospitals for intrahepatic cholangiocarcinoma (iCCA) and patterns of care in daily clinical practice. Patients and methods: An observational retrospective study was conducted on the French National Hospital Discharge Database. All patients with a new diagnosis of iCCA who had a first hospital stay (S1) from January 2016 to December 2021 were included. They were followed up until December 2021, or in-hospital death, whichever occurred first. Crude annual hospitalization rates were computed. Treatment lines were identified with an artificial intelligence algorithm [Analysis of Treatment Lines using Alignment of Sequences (ATLAS)]. A multistate model was used to compute the transition rates between lines. Results: Overall, 13 491 patients were included and the mean (standard deviation) follow-up duration was 13.1 months (17.9 months). The median age at S1 was 72.0 years and 55.9% were male. Nearly 20.7% were admitted via emergency services for S1, and 32.1% had metastases. Between 2016 and 2021, the crude annual rate of new iCCA cases increased from 3.08 [95% confidence interval (CI) 2.94-3.24] in 2016 (n = 1598) to 4.12 (95% CI 3.95-4.29) per 100 000 adult person-years in 2021 (n = 2188). Among 4855 patients receiving first-line systemic therapy (L1), 37.7% (95% CI 36.0% to 39.3%) received a second-line 2 (L2) during the follow-up. The median time between the start of L1 and the beginning of L2 was 7.0 months. Conclusions: This study provides up-to-date national real-world data on iCCA, revealing an increasing burden year by year in France, a poor outcome of patients with iCCA on L1 systemic therapy, and the low proportion of patients receiving an L2.http://www.sciencedirect.com/science/article/pii/S2949819825000214biliary tract cancerreal-world dataCisGemFOLFOXartificial intelligence |
| spellingShingle | M. Delaye B. Grenier A. Lièvre C. Neuzillet Intrahepatic cholangiocarcinoma trends and treatment lines: real-world evidence from the French National Hospital Discharge database ESMO Gastrointestinal Oncology biliary tract cancer real-world data CisGem FOLFOX artificial intelligence |
| title | Intrahepatic cholangiocarcinoma trends and treatment lines: real-world evidence from the French National Hospital Discharge database |
| title_full | Intrahepatic cholangiocarcinoma trends and treatment lines: real-world evidence from the French National Hospital Discharge database |
| title_fullStr | Intrahepatic cholangiocarcinoma trends and treatment lines: real-world evidence from the French National Hospital Discharge database |
| title_full_unstemmed | Intrahepatic cholangiocarcinoma trends and treatment lines: real-world evidence from the French National Hospital Discharge database |
| title_short | Intrahepatic cholangiocarcinoma trends and treatment lines: real-world evidence from the French National Hospital Discharge database |
| title_sort | intrahepatic cholangiocarcinoma trends and treatment lines real world evidence from the french national hospital discharge database |
| topic | biliary tract cancer real-world data CisGem FOLFOX artificial intelligence |
| url | http://www.sciencedirect.com/science/article/pii/S2949819825000214 |
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