P-10 LATIN AMERICAN REGISTRY OF CHOLANGIOCARCINOMA: CLINICAL FEATURES, MANAGEMENT AND OUTCOMES

da Fonseca, Leonardo G.; Izquierdo-Sanchez, Laura; Hashizume, Pedro H.; Beca, Estefanía Liza; Carlino, Yanina; Carrera, Enrique; Arrese, Marco; Ferrer, Javier Díaz; Balderramo, Domingo; Carrilho, Flair J.; Boonstra, Andre; Debes, Jose D.; de Oliveira, Claudia Pinto Marques Souza; Banales, Jesus M.

doi:10.1016/j.aohep.2021.100376

ISSN: 1665-2681

Annals of Hepatology (AoH) is an international, open access journal published bi-monthly with funds from the Fundación Clínica Médica Sur. It is the official journal of the Mexican Association of Hepatology (AMH), the Latin American Association for the Study of the Liver (ALEH), the Canadian Association for the Study of the Liver (CASL) and the Czech Society of Hepatology (CSH). AoH publishes editorials, opinions, concise reviews, original articles, brief reports, letters to the editor, news from affiliated associations, clinical practice guidelines and summaries of congresses in the field of Hepatology.

Topics covered by AoH include alcoholic liver disease, autoimmune hepatitis, biliary diseases, drug-induced liver injury, genetic liver diseases, NAFLD/NASH and viral hepatitis (HAV, HBV, HCV, HDV, HEV). Our journal seeks to publish articles on basic clinical care and translational research focused on preventing rather than treating the complications of end-stage liver disease.

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Leonardo G. da Fonseca1,2, Laura Izquierdo-Sanchez3, Pedro H. Hashizume2, Estefanía Liza Beca4, Yanina Carlino5, Enrique Carrera6, Marco Arrese7, Javier Díaz Ferrer4,8, Domingo Balderramo5, Flair J. Carrilho1,9, Andre Boonstra10, Jose D. Debes10,11, Claudia Pinto Marques Souza de Oliveira12, Jesus M. Banales3,13,14

1 São Paulo Clínicas Liver Cancer GroupClinical Oncology

2 Instituto do Câncer do Estado de São Paulo, University of Sao Paulo, Brazil

3 Department of Liver and Gastrointestinal Diseases, Biodonostia Health Research Institute, Donostia University Hospital, University of the Basque Country (UPV/EHU), 20014 San Sebastian, Spain

4 Departamento del Aparato Digestivo, Hospital Edgardo Rebagliati-EsSalud

5 Gastroenterology Department, Hospital Privado Universitário de Córdoba, Instituto Universitario de Ciências Biomédicas de Córdoba, Córdoba, Argentina

6 Department of Gastroenterology and Hepatology, Hospital Eugenio Espejo, Quito, Ecuador

7 Departamento de Gastroenterología, Facultad de Medicina, and Centro de Envejecimiento y Regeneracion (CARE), Departamento de Biologia Celular y Molecular, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Santiago, Chile

8 Facultad De Medicina. Universidad Nacional Mayor de San Marcos, Lima -Perú

9 Hospital das Clínicas Complex, Division of Clinical Gastroenterology and Hepatology, Department of Gastroenterology, University of São Paulo School of Medicine, São Paulo, Brazil

10 Department of Gastroenterology and Hepatology, Erasmus MC, Rotterdam, NL

11 Department of Medicine, University of Minnesota, Minneapolis, MN, US

12 Department of Gastroenterology, Clinical Division, Hepatology Branch, University of São Paulo School of Medicine, São Paulo, Brazil

13 National Institute for the Study of Liver and Gastrointestinal Diseases, CIBERehd, Instituto de Salud Carlos III, 28029 Madrid, Spain

14 Ikerbasque, Basque Foundation for Science, 48013 Bilbao, Spain

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Special issue

This article is part of special issue:

Vol. 24. Issue S1

Abstracts of the 2021 Annual meeting of the ALEH (Asociación Latinoamericana para el Estudio del Hígado)

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Introduction

Cholangiocarcinoma (CCA) includes a heterogeneous group of biliary cancers with dismal prognosis and increasing incidence. Information on epidemiology and risk factors are scarce, particularly in Latin America.

Aim

Describe and analyze a multicentric cohort of CCA patients from Latin America.

Methods

The Ibero-Latin American Research Network on Cholangiocarcinoma (ILARN-CCA) Registry and ESCALON consortium (www.escalon.eu) collected data from patients diagnosed from 2010 and onwards.

Results

183 patients with histologically/cytologically confirmed CCA were included from 5 tertiary hospitals (Brazil,Argentina,Chile,Ecuador and Peru). Median age at diagnosis was 62 years-old (IQR:25-87) and 55.7% were women. Most frequent risk factors were overweight/obesity (n=68;31.1%), diabetes (n=35;19.1%), NAFLD (n=14;7.7%), viral hepatitis (n=5;2.7%), cirrhosis (n=4;2.2%), gallstones (n=10;5.5%), primary sclerosing cholangitis (n=11;6%) and 21.3%(n=39) had no known-risk factor. Intrahepatic CCA was the predominant type (n=73;39.9%), followed by distal (n=49;26.8%) and perihilar (n=38;20.8%). Regional lymph-node invasion was found in 74 (40.4%) and metastasis in 79 (43.2%) patients. Upon diagnosis, 88 patients (48.1%) required upfront biliary stenting prior to main treatments, consisting in resection (n=39;21.3%) or palliative modalities (n=135;73.8%). Recurrence occurred in 64.1%(n=25), with median time-to-recurrence of 13.5 months (95%CI:6.5-18.8). Chemotherapy was delivered to 120 patients (Gemcitabine+Cisplatin:n=105;87.5%) with a median progression-free survival of 4.2 months (95%CI:3.4-4.9). Median overall survival of the entire cohort was 8.2 months (n=183;95%CI:6.3-10.2), 22.5 (n=39;95%CI:11.6-34.1) under surgery, 10.4 (n=87;95%CI:8.4-13.6) under chemotherapy and 2.5 (n=30;95%CI:1.5-3.9) without active treatments (log-rank p<0.001).

Conclusion

CCA is associated to diverse etiologies in Latin-America, particularly metabolic disorders. Surgical resection shows favorable outcome, highlighting the need of surveillance strategies in individuals at risk.

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