CHOLANGIOCARCINOMA, CHARACTERISTICS AND PRESENTATION IN A REFERRAL HOSPITAL IN LIMA, PERU

Introduction and Objectives

Cholangiocarcinoma (CCA) is an aggressive and heterogeneous malignant neoplasm, with a rising global incidence contributing to high mortality. Associated comorbidities are not well established, and overall survival is poor. In Peru, there is a lack of systematic characterization of this disease. the objetives are to describe the clinical, epidemiological, and therapeutic characteristics of hospitalized patients with CCA, and to assess recurrence, progression, mortality, and survival rates by therapeutic subgroups.

Materials and Methods

An observational, descriptive, and retrospective study was conducted using electronic medical records of 67 patients hospitalized with CCA between January 2020 and December 2024. Clinical, diagnostic, therapeutic, and survival data were collected. Patients without follow-up or a definitive diagnosis were excluded.

Results

The mean age was 64.5 years. The most common comorbidities were hypertension (19.4%), biliary tract diseases (17.9%), and type 2 diabetes (14.9%). Extrahepatic CCA was found in 55.2% of cases, with the mass-forming pattern being the most frequent (47.7%). Curative-intent surgery was performed in 23.9% (R0 resection in 17.9%), and first-line chemotherapy was administered in 20.9%. Median overall survival was 7.2 months.

Conclusions

Most hospitalized patients with CCA presented with extrahepatic and advanced-stage disease, limiting curative treatment options and resulting in low overall survival.

Conflict of interest: None

Table 1: Characteristics of patients with CCA

Characteristic	Total	iCCA	pCCA	dCCA
	n = 67	n = 30	n = 23	n = 14
Age, median	64.5	62.9	67.3	63.1
Gender (female), n (%)	32 (47.8)	18 (60)	9 (39.1)	5 (35.7)
ECOG, n (%)
0-1	39 (58.2)	14 (46.7)	12 (52.2)	13 (92.9)
≥2	28 (41.8)	16 (53.3)	11 (47.8)	1 (7.1)
Stage at diagnosis, n (%)
Localized	17 (25.4)	5 (16.7)	3 (13)	9 (64.3)
Regional invasion	16 (23.9)	6 (20)	7 (30.5)	3 (21.4)
Distant metastasis	34 (50.7)	19 (63.3)	13 (56.5)	2 (14.3)
Primary tumor lesions, n (%)
Single lesion	52 (77.6)	15 (50)	23 (100)	14 (100)
Multiple lesions	15 (22.4)	15 (50)	0 (0)	0
Pattern of growth, n(%)
Mass-forming	32 (47.8)	30 (100)	2 (8.7)	0 (0)
Periductal infiltrating	21 (31.3)	0 (0)	11 (47.8)	10 (71.4)
Intraductal growth	14 (20.9)	0 (0)	10 (43.5)	4 (28.6)
Tumor resection, n(%)
R0	12 (17.9)	2 (6.7)	3 (13)	7 (50)
R1	4 (6)	1 (3.3)	0 (0)	3 (21.4)
Adyuvant chemotheray	5 (7.5)	0 (0)	1 (4.3)	4 (28.6)
Recurrence, n (%)	4 (6)	3 (10)	0 (0)	1 (7.1)
Recurrence-free survival	10.9	5.5	-	27.3
Chemotherapy, n(%)
Gemcitabine/Cisplatin	10 (14.9)	10 (33.3)	0 (0)	0 (0)
Other	4 (6)	4 (13.3)	0 (0)	0 (0)
Progression, n(%)	9 (13.4)	9 (30)	-	-
Progression-free survival	5.3	5.3	-	-
Best supportive care, n (%)
Biliary stent	20 (29.8)	3 (10)	15 (65.2)	2 (14.3)
Other	17 (25.4)	10 (33.3)	5 (21.7)	2 (14.3)