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Risk factors for perihilar cholangiocarcinoma: A hospital-based case-control study

 Ban Seok Lee  ;  Byung Hyo Cha  ;  Jaehoon Roh  ;  Eun Cheol Park 
 LIVER INTERNATIONAL, Vol.35(3) : 1048-1053, 2015 
Journal Title
Issue Date
Aged ; Aged, 80 and over ; Bile Duct Neoplasms/epidemiology ; Bile Duct Neoplasms/etiology* ; Case-Control Studies ; Female ; Humans ; Klatskin Tumor/epidemiology ; Klatskin Tumor/etiology* ; Male ; Middle Aged ; Multivariate Analysis ; Republic of Korea/epidemiology ; Risk Factors
choledocholithiasis ; diabetes mellitus ; hepatolithiasis ; perihilar cholangiocarcinoma ; risk factor
BACKGROUND & AIMS: Perihilar cholangiocarcinoma (pCCA) is the most common form of bile duct cancer, arising from cholangiocytes at the confluence of hepatic ducts. Given the diversity of cholangiocarcinoma (CCA) aetiology according to the location, and the scarcity of studies on the aetiology of pCCA, we aimed to identify the risk factors for pCCA.
METHODS: A total of 81 patients diagnosed with pCCA between July 2007 and December 2013, and 162 controls matched 2:1 for age, sex and date of diagnosis were included in this hospital-based case-control study. Potential risk factors were retrospectively investigated through clinical records, and the associations with pCCA were studied by calculating the odds ratios (ORs) using conditional logistic regression analysis.
RESULTS: In the univariate model, the prevalence of choledocholithiasis (OR: 14.00, P = 0.014), hepatolithiasis (OR: 12.00, P = 0.021) and diabetes mellitus (DM) (OR: 2.74, P = 0.005) was higher in pCCA patients than in controls. Heavy smoking and cirrhosis were marginally significant risk factors for pCCA (P < 0.1). Multivariate analysis revealed an association between pCCA and hepatolithiasis, choledocholithiasis, DM, and heavy smoking, each, with adjusted ORs of 16.47, 9.39, 3.36 and 2.52 respectively. DM, heavy smoking, hepatolithiasis and choledocholithiasis accounted for about 22.5%, 17.1%, 8.5% and 4.8% of pCCA risk respectively (population attributable risk percentage).
CONCLUSION: Our data showed that DM, heavy smoking, choledocholithiasis and hepatolithiasis were risk factors for pCCA development, implying that pCCA may share some aetiological factors with intrahepatic CCA although it has been classified as extrahepatic CCA.
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1. College of Medicine (의과대학) > Dept. of Preventive Medicine (예방의학교실) > 1. Journal Papers
Yonsei Authors
Roh, Jae Hoon(노재훈)
Park, Eun-Cheol(박은철) ORCID logo https://orcid.org/0000-0002-2306-5398
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