- Volume 17 Issue 1
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Cholangiocarcinoma Patient Outcome in Northeastern Thailand: Single-Center Prospective Study
- Luvira, Vor (Department of Surgery, Faculty of Medicine, Khon Kaen University) ;
- Nilprapha, Kasama (Department of Surgery, Faculty of Medicine, Khon Kaen University) ;
- Bhudhisawasdi, Vajarabhongsa (Department of Surgery, Faculty of Medicine, Khon Kaen University) ;
- Pugkhem, Ake (Department of Surgery, Faculty of Medicine, Khon Kaen University) ;
- Chamadol, Nittaya (Department of Radiology, Faculty of Medicine, Khon Kaen University) ;
- Kamsa-ard, Supot (Cancer Unit, Srinagarind Hospital, Faculty of Medicine, Khon Kaen University)
- Published : 2016.02.05
Background: Cholangiocarcinoma is relatively rare worldwide. Most previous reports collected only patients with pathological diagnosis. In fact, however, many patients coming to hospital are diagnosed by clinical suspicion with radiologic imaging and receive treatment without histological confirmation. Real survival data and outcome of each treatment, especially for patients that do not have histologic confirmation, are lacking. In this study, therefore, we aimed to analyze the survival rates of CCA patients and the proportions of patients receiving different treatments. Materials and Methods: A total of 270 patients clinically suspected of CCA and visiting Srinagarind Hospital in May-July 2010, were prospectively followed until December 2014. After checking their clinical records, 163 of 270 patients were finally diagnosed as having CCA, and the data of this group were analyzed for survival rate and received treatments. Results: Of the 163 patients, 96 (58.9%) had intrahepatic, 56 (34.4%) had perihilar and 11 (6.7%) had distal CCA. The majority [107 (65.6%, 95%CI, 57.8-73.0)] received only supportive care. Overall median survival was 4 months (95%CI, 3.3-4.7), and 2-years survival was only 8.1% (95%CI,4.5-12.9). However, the 4 year survival of the R0 resection group was 100%. Conclusions: The present results show that the prognosis of CCA is very poor in North-east Thailand. Most CCA patients receive only treatment to alleviate symptoms due to their advanced stage of disease. Complete surgical resection at the early stage is the only treatment that significantly improves patient survival.
Cholangiocarcinoma;treatment;surgical resection;survival rate
- Alexopoulou A, Soultati A, Dourakis SP, et al (2008). Cholangiocarcinoma: A 7-year experience at a single center in Greece. World J Gastroenterol, 14, 6213-7. https://doi.org/10.3748/wjg.14.6213
- Cancer Unit, Faculty of Medicine, Khon Kaen University (2009). Hospital based tumor registry: statistical report 2008, Khon Kaen: Thailand; 2009.
- Carriaga MT and Henson DE (1995) Liver gallbladder extrahepatic bile ducts and pancreas. Cancer, 75, 171-90. https://doi.org/10.1002/1097-0142(19950101)75:1+<171::AID-CNCR2820751306>3.0.CO;2-2
- DeOliveira ML, Cunningham SC, Cameron JL, et al (2007): thirty-one-year experience with 564 patients at a single institution. Ann Surg, 245, 755-62. https://doi.org/10.1097/01.sla.0000251366.62632.d3
- Edge SB, Byrd DR (2010) AJCC Cancer staging manual. 7th ed. 2010. Springer-Verlag New York.
- EpiData Software [homepage on the Internet]. [update 2015 January 1; cited 2015 Jan] Available from: http://www.epidata.dk
- International Association of Cancer Registries [homepage on the Internet]. Lyon: [update 2015 January 1; cited 2015 Jan]. Available from: http://www.iacr.com.fr.
- Kamsa-ard S, Wiangnon S, Suwanrungruang K, et al (2011). Trends in liver cancer incidence between 1985 and 2009 Khon Kaen Thailand: cholangiocarcinoma. Asian Pac J Cancer Prev, 12, 2209-13.
- Khan SA, Davidson BR, Goldin RD, et al (2012). Guidelines for the diagnosis and treatment of cholangiocarcinoma. Gut, 61, 1657-69. https://doi.org/10.1136/gutjnl-2011-301748
- Park J, Kim M-H, Kim K-P, et al (2009). Natural history and prognostic factors of advanced cholangiocarcinoma without surgery chemotherapy or radiotherapy: a large-scale observational study. Gut Liver, 3, 298-305. https://doi.org/10.5009/gnl.2009.3.4.298
- Qin X-L, Wang Z-R, Shi J-S, et al (2004). Utility of serum CA19-9 in diagnosis of cholangiocarcinoma: in comparison with CEA. World J Gastroenterol, 10, 427-32. https://doi.org/10.3748/wjg.v10.i3.427
- Razumilava N and Gores GJ (2014). Cholangiocarcinoma. Lancet, 383, 2168-79. https://doi.org/10.1016/S0140-6736(13)61903-0
- Stata Data Analysis and Statistical Software [homepage on the Internet]. [update 2015 January 1; cited 2015 Jan] Available from: http://www.stata.com.
- Yusoff AR, Razak MMA, Yoong BK, et al (2012). Survival analysis of cholangiocarcinoma: a 10-year experience in Malaysia. World J Gastroenterol, 18, 458-65. https://doi.org/10.3748/wjg.v18.i5.458
- Current Perspectives on Opisthorchiasis Control and Cholangiocarcinoma Detection in Southeast Asia vol.5, pp.2296-858X, 2018, https://doi.org/10.3389/fmed.2018.00117
- Programmed knockout mutation of liver fluke granulin attenuates virulence of infection-induced hepatobiliary morbidity vol.8, pp.2050-084X, 2019, https://doi.org/10.7554/eLife.41463
- Adjuvant chemotherapy improves oncological outcomes of resectable intrahepatic cholangiocarcinoma vol.98, pp.5, 2019, https://doi.org/10.1097/MD.0000000000014013