AB066. P-37. Epidemiology study of extrahepatic cholangiocarcinoma in Korea

Background: The biliary tract cancer including gallbladder cancer is 8^th–9^th common cancer in Korea. Bile duct cancer is much more common in Asia and the Middle East. However, the incidence of extrahepatic cholangiocarcinoma (ECC) is decreasing because of decreased liver fluke infection which is the most important risk factor of ECC. The survival of bile duct cancer has been improved, but, unsatisfactory till now. We tried to assess the Korean epidemiology of ECC.

Methods: Epidemiologic survey was performed by physicians working in tertiary referral hospital by using Electronic Recording System. As basic information, age, sex, job and occupied area were collected. As risk factors, chronic inflammatory bile duct disease, chemical and carcinogens, autoimmune diseases, chronic liver diseases and history of raw freshwater fish or snail ingestion were collected. We also collected laboratory data and clinical symptoms. We confirmed the bile duct cancer using radiologic diagnosis, pathologic diagnosis and clinical diagnosis. We also assessed TNM staging, Bismuth type and treatment modality.

Results: Mean total bilirubin level, aspartate aminotransferase (AST), alanine aminotransferase (ALT) and alkaline phosphatase (ALP) levels were elevated as well as mean Tumor marker levels. ECC is more prevalent in women. Peak age is around seventies. ECC is more prevalent in Seoul, Chelabukdo and Keongdan buk do. Liver cirrhosis and chronic hepatitis B were identified as the important risk factors. Prevalence of clonorchiasis (13/812, 1.6%) is relatively lower than previous data. Old age, diabetes mellitus (DM), alcohol, smoking and History of raw freshwater fish or snail ingestion were also related with ECC. Jaundice is the most common symptom. In case of perihilar cholangiocarcinoma (CCC), most cases were diagnosed as advanced stages (158/258). In distal CCC, advanced stages were relatively lower. Curative resection, biliary drainage and chemotherapy were the main treatment modalities.

Conclusions: The ECC were more prevalent in southern part of Korea and in female. The infection incidence of clonorchiasis was decreasing compared to previous study. Perihilar CCC were more commonly diagnosed as advanced stages compared to distal CCC.

Keywords: Epidemiology; extrahepatic; cholangiocarcinoma; liver fluke