In Italy, biliary tract tumors affect 20% more in the South than in the North. Unlike almost all other gastrointestinal neoplasms, in the South there are +18% of cases among the male population and +23% among the female population. Although they are rare oncological diseases, they affect a total of more than 12 thousand people in our country alone. This is what emerged at the conference ‘Cholangiocarcinoma: new perspectives’ at the A. Gemelli Irccs University Hospital, promoted by the Italian Cholangiocarcinoma Patients Association (Apic) on the occasion of the World Day dedicated to this neoplasm.
“It is still an unrecognized disease despite the fact that it is on the increase in our country – states Paolo Leonardi, Apic president -. One of the main problems we encounter is, in fact, access to safe and certified information by patients, family members and caregivers. For We promote this event because greater awareness on the part of all the actors involved is the first step in containing a very complex pathology.”
Cholangiocarcinoma or tumor of the biliary tract “originates in the ducts in which bile is transported from the liver to the intestine – underlines Giampaolo Tortora, director of the Comprehensive Cancer Center of the Gemelli Polyclinic -. The differences in incidence between the North and the South of the country could be partly explained through a risk factor such as obesity. Severe excess weight in Italy has higher rates among the population, both adults and children, in various southern regions. The neoplasm mainly affects older men and women between the ages of 50 and 80. In the majority of cases it presents suddenly in the absence of risk factors or pre-cancer conditions. Therefore one in four diagnoses occurs completely randomly through tests or investigations carried out for other health reasons We are therefore often forced to carry out therapeutic interventions on advanced-stage disease. This explains why the five-year survival rates for men and women stand at only 17% and 15% respectively.”
Surgery, continues Lorenza Rimassa, associate of Medical Oncology at Humanitas University, “is one of the most used treatments even if after surgery in approximately 60% of cases the neoplasm tends to recur. Furthermore, the tumor responds poorly to radiotherapy and chemotherapy, which still offers benefits both for patients who have undergone surgery and for patients with inoperable or relapsed disease. The innovations of recent years, however, are immunotherapy which, administered together with chemotherapy, has been shown to significantly increase overall survival and disease-free, and molecular targeted therapies that allow selective action on specific targets present on tumor cells. For this reason it is now essential that patients with cholangiocarcinoma are offered the possibility of molecular profiling of the neoplasm, in order to identify the presence of alterations that can be targets of targeted drugs”.
“These are encouraging signs for us patients even if a long way remains to be covered – concludes Leonardi -. There is a need for greater commitment to identify new diagnostic-therapeutic tools capable of further improving survival from this gastro-intestinal tumor. In particular, it is necessary to offer all patients molecular profiling tests and finally they must be evaluated by an expert and dedicated multidisciplinary team.”
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