Intrahepatic cholangiocarcinoma hidden within cancer of unknown primary
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Authors
Conway, Alicia-MarieMorris, G. C.
Smith, Sarah
Vekeria, Monique
Manoharan, Prakash
Mitchell, Claire L
Backen, Alison C
Oliveira, Pedro
Hubner, Richard A
Lamarca, Angela
McNamara, Mairead G
Valle, Juan W
Cook, Natalie
Affiliation
Cancer Research UK Manchester Institute Cancer Biomarker Centre, The University of Manchester, Manchester, UKIssue Date
2022
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Background: Many patients referred with a provisional diagnosis of cancer of unknown primary (pCUP) present with presumed metastatic disease to the liver. Due to the lack of definitive histological markers, intrahepatic cholangiocarcinoma (iCCA) may be overlooked. This study assessed the frequency of iCCA within a pCUP cohort. Methods: A single UK cancer-center study of sequential patients referred with pCUP from January 2017 to April 2020. Baseline diagnostic imaging was reviewed independently by a radiologist and oncologist; those with radiological features of iCCA (dominant liver lesion, capsular retraction) were identified. Results: Of 228 patients referred with pCUP, 72 (32%) had malignancy involving the liver. 24/72 patients had radiological features consistent with iCCA; they were predominantly female (75%) with an average age of 63 years and 63% had an ECOG PS ≤ 2. The median overall survival (OS) of the iCCA group and the remaining liver-involved CUP group were similar (OS 4.1 vs 4.4 months, p-value = 0.805). Patients, where a primary diagnosis was subsequently determined, had better OS (10.2 months, p-values: iCCA = 0.0279: cCUP = 0.0230). Conclusions: In this study, 34% of patients with liver-involved pCUP, fulfilled the radiological criteria for an iCCA diagnosis. Consideration of an iCCA diagnosis in patients with CUP could improve timely diagnosis, molecular characterisation and treatment.Citation
Conway AM, Morris GC, Smith S, Vekeria M, Manoharan P, Mitchell C, et al. Intrahepatic cholangiocarcinoma hidden within cancer of unknown primary. British Journal of Cancer. Springer Science and Business Media LLC; 2022.Journal
British Journal of CancerDOI
10.1038/s41416-022-01824-4PubMed ID
35484217Additional Links
https://dx.doi.org/10.1038/s41416-022-01824-4Type
ArticleLanguage
enae974a485f413a2113503eed53cd6c53
10.1038/s41416-022-01824-4
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