{"title":"肝内胆管癌的趋势和治疗路线:来自法国国家医院出院数据库的真实证据","authors":"M. Delaye , B. Grenier , A. Lièvre , C. Neuzillet","doi":"10.1016/j.esmogo.2025.100152","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Little is known about the therapeutic trajectory of patients treated in hospitals for intrahepatic cholangiocarcinoma (iCCA) and patterns of care in daily clinical practice.</div></div><div><h3>Patients and methods</h3><div>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.</div></div><div><h3>Results</h3><div>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 (<em>n</em> = 1598) to 4.12 (95% CI 3.95-4.29) per 100 000 adult person-years in 2021 (<em>n</em> = 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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":100490,"journal":{"name":"ESMO Gastrointestinal Oncology","volume":"8 ","pages":"Article 100152"},"PeriodicalIF":0.0000,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Intrahepatic cholangiocarcinoma trends and treatment lines: real-world evidence from the French National Hospital Discharge database\",\"authors\":\"M. Delaye , B. Grenier , A. Lièvre , C. Neuzillet\",\"doi\":\"10.1016/j.esmogo.2025.100152\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>Little is known about the therapeutic trajectory of patients treated in hospitals for intrahepatic cholangiocarcinoma (iCCA) and patterns of care in daily clinical practice.</div></div><div><h3>Patients and methods</h3><div>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.</div></div><div><h3>Results</h3><div>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 (<em>n</em> = 1598) to 4.12 (95% CI 3.95-4.29) per 100 000 adult person-years in 2021 (<em>n</em> = 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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>\",\"PeriodicalId\":100490,\"journal\":{\"name\":\"ESMO Gastrointestinal Oncology\",\"volume\":\"8 \",\"pages\":\"Article 100152\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-03-04\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"ESMO Gastrointestinal Oncology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2949819825000214\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"ESMO Gastrointestinal Oncology","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2949819825000214","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
背景:对于医院治疗肝内胆管癌(iCCA)患者的治疗轨迹和日常临床实践中的护理模式知之甚少。患者和方法在法国国家医院出院数据库中进行了一项观察性回顾性研究。2016年1月至2021年12月期间首次住院(S1)的所有新诊断为iCCA的患者均被纳入研究。他们被随访到2021年12月,或在医院死亡,以先发生者为准。计算粗年住院率。使用人工智能算法[利用序列比对分析处理系(ATLAS)]识别处理系。采用多状态模型计算线间转换速率。结果共纳入13 491例患者,平均(标准差)随访时间为13.1个月(17.9个月)。S1时的中位年龄为72.0岁,55.9%为男性。近20.7%的S1患者通过急诊就诊,32.1%的患者有转移。2016年至2021年间,iCCA新发病例的年粗发病率从2016年的3.08例(95%可信区间(CI) 2.94-3.24) (n = 1598)上升至2021年的4.12例(95% CI 3.95-4.29) / 10万成人年(n = 2188)。在4855名接受一线全身治疗(L1)的患者中,37.7% (95% CI 36.0%至39.3%)在随访期间接受了二线2 (L2)治疗。从L1开始到L2开始的中位时间为7.0个月。该研究提供了最新的国家iCCA数据,揭示了法国iCCA负担逐年增加,L1全身治疗的iCCA患者预后不佳,接受L2的患者比例较低。
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 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.