Cholangiocarcinoma (CCA) or bile duct cancer, is a rare, aggressive liver cancer with a poor prognosis, which occurs mostly in people older than age 50.

It is often diagnosed when it is advanced, making successful treatment difficult to achieve.

In an effort to better understand and treat this condition, researchers from Boston University Chobanian & Avedisian School of Medicine compared the characteristics and outcomes of the squamous cell carcinoma (SCC) subtype, with the adenocarcinoma (ADC) subtype in both intrahepatic and extrahepatic bile ducts and found that SCC of the bile ducts is much more aggressive than the more common ADC.

“We found SCC tumours tend to be larger and more advanced when diagnosed, leading to shorter survival times for patients. This is novel because it reveals that SCC behaves differently from ADC, suggesting that these two types of bile duct cancer might need different approaches to treatment,” explained corresponding author Eduardo Vega, MD, assistant professor of surgery at the school.

Using data from the National Cancer Database, the researchers reviewed a group of more than 82,000 patients who had bile duct cancer, specifically comparing those with SCC and those with ADC.

They analysed how big the tumours were, how advanced the cancer was, and how long patients survived after diagnosis.

This allowed them to see clear differences between the two types of cancer.

According to the researchers, these finding are important because it shows that patients with SCC of the bile ducts are at a higher risk and may need more aggressive treatment compared to those with ADC.

“Understanding these differences can lead to better treatment strategies and improve the survival chances for patients with SCC,” said Vega.

Beyond the main findings, Vega believes this study suggests that there could be molecular or genetic differences between SCC and ADC that make SCC more aggressive.

"We hope that our findings will pave the way for more personalised treatment strategies for patients with bile duct cancers, ultimately improving their survival and quality of life. By understanding the unique challenges posed by squamous cell carcinoma, we aim to contribute to the development of more effective therapies for this aggressive cancer."

These findings appear online in the Annals of Surgical Oncology.

Source: Boston University School of Medicine