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©The Author(s) 2024.
World J Gastrointest Oncol. Apr 15, 2024; 16(4): 1374-1383
Published online Apr 15, 2024. doi: 10.4251/wjgo.v16.i4.1374
Published online Apr 15, 2024. doi: 10.4251/wjgo.v16.i4.1374
Table 1 Distribution of demographic and clinical characteristics among types of biliary tract cancers, n (%)
| Characteristics | Ampulla of Vater, n = 7268 | Intrahepatic bile duct, n = 11466 | Extrahepatic bile duct, n = 12869 | Gallbladder, n = 15883 |
| Sex | ||||
| Female | 3347 (46.1) | 5560 (49.4) | 6141 (47.7) | 11446 (72.1) |
| Male | 3921 (53.9) | 5806 (50.6) | 6728 (52.3) | 4437 (27.9) |
| Race | ||||
| White | 5763 (79.3) | 8957 (78.1) | 10092 (78.4) | 12530 (78.9) |
| American Indian/Alaska native | 57 (0.8) | 119 (1) | 120 (0.9) | 269 (1.7) |
| Asian or Pacific Islander | 888 (12.2) | 1513 (13.2) | 1641 (12.8) | 1467 (9.2) |
| Black | 560 (7.7) | 877 (7.7) | 1016 (7.9) | 1617 (10.2) |
| Ethnicity | ||||
| Hispanic | 1174 (16.2) | 1548 (13.5) | 1678 (13.0) | 3071 (19.3) |
| Non-Hispanic | 6094 (83.8) | 9918 (86.5) | 11191 (87.0) | 12812 (80.7) |
| Age | ||||
| ≤ 60 yr | 2040 (28.1) | 3337 (29.1) | 2881 (22.4) | 3694 (23.3) |
| > 60 yr | 5228 (71.9) | 8129 (70.9) | 9988 (77.6) | 12189 (76.7) |
| Stage | ||||
| Local | 738 (10.2) | 1641 (14.3) | 1379 (10.7) | 995 (6.3) |
| Regional | 2522 (34.7) | 2189 (19.1) | 3025 (23.5) | 3594 (22.6) |
| Distant | 824 (11.3) | 2859 (24.9) | 2532 (19.7) | 3607 (22.7) |
| Unknown/un-staged | 3184 (43.8) | 4777 (41.7) | 5933 (46.1) | 7687 (48.4) |
| Grade | ||||
| Well differentiated, I | 1016 (14.0) | 478 (4.2) | 1021 (7.9) | 1805 (11.4) |
| Moderately differentiated, II | 3039 (41.8) | 1688 (14.7) | 2415 (18.8) | 4608 (29.0) |
| Poorly differentiated, III | 1720 (23.7) | 1631 (14.2) | 1926 (15.0) | 4769 (30.0) |
| Undifferentiated; anaplastic, IV | 72 (1.0) | 72 (0.6) | 82 (0.6) | 231 (1.5) |
| Unknown | 1421 (19.5) | 7597 (66.3) | 7425 (57.7) | 4470 (28.1) |
| Marital status | ||||
| Married | 4185 (57.6) | 6449 (56.2) | 7032 (54.6) | 7664 (48.3) |
| Divorced | 604 (8.3) | 1071 (9.3) | 1102 (8.6) | 1399 (8.8) |
| Single, never married | 907 (12.5) | 1452 (12.7) | 1522 (11.8) | 1868 (11.8) |
| Widowed | 1322 (18.2) | 2094 (18.3) | 2764 (21.5) | 4345 (27.4) |
| Unknown | 250 (3.4) | 400 (3.5) | 449 (3.5) | 607 (3.8) |
| Yr of diagnosis | ||||
| 1975-1990 | 796 (11.0) | 684 (6.0) | 1675 (13.0) | 3107 (19.6) |
| 1991-2005 | 2691 (37.0) | 3898 (34.0) | 5513 (34.7) | 5513 (34.7) |
| 2006-2016 | 3781 (52.0) | 6884 (60.0) | 7117 (55.3) | 7263 (45.7) |
| Chemotherapy | ||||
| Yes | 2245 (30.9) | 4445 (38.8) | 4134 (32.1) | 4705 (29.6) |
| No/unknown | 5023 (69.1) | 7021 (61.2) | 8735 (67.9) | 11178 (70.4) |
| Surgery | ||||
| Yes | 1003 (13.8) | 427 (3.7) | 1245 (9.7) | 1787 (11.3) |
| No/unknown | 6265 (86.2) | 11039 (96.3) | 11624 (90.3) | 14096 (88.7) |
| Radiation | ||||
| Yes | 1245 (17.2) | 1604 (14.0) | 2489 (19.4) | 2183 (13.8) |
| No/unknown | 6003 (82.8) | 9831 (86.0) | 10334 (80.6) | 13664 (86.2) |
Table 2 Associations of baseline characteristics and clinical factors with 5-year survival outcomes following diagnosis using multivariate Cox regression analysis
| Parameter | Hazard ratio | 95%CI | P value |
| Site | |||
| Ampullary carcinoma | 1 | ||
| Intrahepatic bile duct carcinoma | 2.17 | 2.08-2.25 | < 0.0001 |
| Extrahepatic bile duct carcinoma | 1.87 | 1.80-1.94 | < 0.0001 |
| Gallbladder carcinoma | 1.68 | 1.62-1.74 | < 0.0001 |
| Sex | |||
| Female | 1 | ||
| Male | 1.07 | 1.05-1.10 | < 0.0001 |
| Race/ethnicity | |||
| White | 1 | ||
| American Indian/Alaska native | 1.02 | 0.93-1.13 | 0.64 |
| Asian or Pacific Islander | 0.93 | 0.90-0.96 | < 0.0001 |
| Black | 1.05 | 1.01-1.09 | 0.03 |
| Hispanic | 0.97 | 0.93-0.99 | 0.03 |
| Age | |||
| ≤ 60 yr | 1 | ||
| > 60 yr | 1.31 | 1.28-1.35 | < 0.0001 |
| Stage | |||
| Local | 1 | ||
| Regional | 1.29 | 1.42-1.56 | < 0.0001 |
| Distant | 3.02 | 2.88-3.16 | < 0.0001 |
| Unknown | 1.90 | 1.81-2.00 | < 0.0001 |
| Grade | |||
| Well differentiated, I | 1 | ||
| Moderately differentiated, II | 1.39 | 1.33-1.46 | < 0.0001 |
| Poorly differentiated, III | 2.17 | 2.07-2.28 | < 0.0001 |
| Undifferentiated; anaplastic, IV | 2.22 | 1.99-2.48 | < 0.0001 |
| Marital status | |||
| Married | 1 | ||
| Divorced | 1.13 | 1.08-1.17 | < 0.0001 |
| Single, never married | 1.13 | 1.09-1.17 | < 0.0001 |
| Widowed | 1.19 | 1.15-1.22 | < 0.0001 |
| Unknown | 0.99 | 0.93-1.05 | 0.63 |
| Year of Diagnosis | |||
| 1975-1990 | 1 | ||
| 1991-2005 | 0.89 | 0.85-0.92 | < 0.0001 |
| 2006-2016 | 0.88 | 0.83-0.92 | < 0.0001 |
| Chemotherapy | |||
| Yes | 1 | ||
| No/unknown | 1.34 | 1.31-1.38 | < 0.0001 |
| Surgery | |||
| Yes | 1 | ||
| No/unknown | 1.30 | 1.23-1.37 | < 0.0001 |
| Radiation | |||
| Yes | 1 | ||
| No/unknown | 1.02 | 0.98-1.07 | 0.26 |
Table 3 Associations of county-level socioeconomic factors with 5-year survival following diagnosis using multivariate Cox regression analysis
| County parameter | Hazard ratio | 95%CI | P value | |
| Urban population, % | Below median | 1 | ||
| Above median | 0.97 | 0.94-0.99 | 0.004 | |
| College education level, % | Below median | 1 | ||
| Above median | 0.96 | 0.93-0.99 | 0.002 | |
| Colorectal cancer screening rates, % | Below median | 1 | ||
| Above median | 0.95 | 0.93-0.97 | < 0.0001 | |
| Income level, per $ 10 | Below median | 1 | ||
| Above median | 0.97 | 0.94-0.99 | 0.04 | |
| Smokers, % | Below median | 1 | ||
| Above median | 1.01 | 0.99-1.04 | 0.42 | |
- Citation: Sahyoun L, Chen K, Tsay C, Chen G, Protiva P. Clinical and socioeconomic determinants of survival in biliary tract adenocarcinomas. World J Gastrointest Oncol 2024; 16(4): 1374-1383
- URL: https://www.wjgnet.com/1948-5204/full/v16/i4/1374.htm
- DOI: https://dx.doi.org/10.4251/wjgo.v16.i4.1374