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Authors Qin BD, Jiao XD, Yuan LY, Liu K, Zang YS
Received 26 June 2017
Accepted for publication 17 December 2017
Published 7 March 2018 Volume 2018:10 Pages 439—446
DOI https://doi.org/10.2147/CMAR.S144850
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Amy Norman
Peer reviewer comments 3
Editor who approved publication: Dr Antonella D'Anneo
Introduction: Adenosquamous
carcinoma (ASC) of the bile duct is a rare diagnosis with poorly understood
clinicopathological characteristics and disease progression, so identification
of the features associated with ASC patient survival is warranted.
Materials and methods: A population cohort study was performed using
prospectively extracted data from the Surveillance, Epidemiology and End
Results (SEER) database for patients with histological diagnoses of ASC of the
bile duct from 1973 to 2013.
Results: A
total of 106 patients with ASC of the bile duct were included (mean age
68.1±13.5 years). Lesions from 58 patients were in the extrahepatic bile duct
and 34 were located at the ampulla of Vater. Fifty-seven patients were
categorized with a regional stage, 15 had localized disease, and 30 had distant
disease. Most (60.4%) patients received cancer-directed surgery, and radiation
was performed in 14.1% of cases. The 1-year, 2-year, and 5-year overall
survival (OS) for patients with ASC of the bile duct was 30.1%, 11.3%, and
3.7%, respectively. Cancer-directed surgery offered 10 additional months of OS
for patients with ASC of the bile duct and median OS was 14.0, 6.0, and 6.0
months for ampulla of Vater, extrahepatic bile duct, and intrahepatic bile duct
cases, respectively. A multivariate Cox analysis showed that lesions in the
ampulla of Vater (HR=0.51, 95% CI 0.26–0.99) and having surgery (HR=0.34, 95%
CI 0.14–0.81) were independent protective prognostic factors for these
patients.
Conclusion: Cancer-directed surgery and a primary lesion
site of the ampulla of Vater may suggest favorable prognosis for patients with
ASC of the bile duct.
Keywords: adenosquamous
carcinoma, bile duct, prognosis, SEER database