How Cholangiocarcinoma Differs in Adolescent and Younger Adults Versus Older Adults

By: Jenna Carter, PhD
Posted: Monday, September 11, 2023

A recent article published in JCO Precision Oncology highlighted the tumor biology, treatment patterns, and survival outcomes of adolescent and young adults (AYAs) with cholangiocarcinoma compared with their older counterparts. Lipika Goyal, MD, MPhil, of Harvard Medical School, Boston, and colleagues conducted the Cholangiocarcinoma in the Young (CITY) study to compare disease outcomes in patients aged 50 and younger with those of patients older than 50. Overall, their findings revealed that young patients had a larger median tumors and node-positive disease at resection but a higher median overall survival compared with older patients.

“Although prioritization has historically been given to pediatric and adult populations with cancer, increasing recognition of AYAs as a unique entity allows for tailored interventions to support this previously underrecognized population of patients with cancer,” stated Dr. Goyal and colleagues.

A total of 847 patients met eligibility requirements and were included in this multi-institutional cohort of patients with cholangiocarcinoma. Patients were either diagnosed with intrahepatic or extrahepatic cholangiocarcinoma. Data on tumor size, tumor biology, treatment type, and survival outcomes were analyzed and compared based on specific age groups.

Findings revealed that younger patients had a larger median tumor size (4.2 vs. 3.6 cm; P = .048), more commonly had N1 disease (65% vs. 43%; P = .040), and were more likely to receive adjuvant therapy (odds ratio = 4.0; 95% confidence interval [CI] = 1.64–9.74) than older patients. Younger patients were also more likely to receive targeted therapy (23% vs. 8%; P < .001), palliative systemic therapy (96% vs. 69%; P < .001), and clinical trial treatment (31% vs. 19%; P = .004). Additionally, younger patients who presented with advanced disease had a higher median overall survival than their older counterparts (17.7 vs. 13.5 months; 95% CI = 12.6–22.6 vs. 11.4–14.8 months; P = .049).

Disclosure: For full disclosures of the study authors, visit ascopubs.org.

JCO Precision Oncology

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