Survival of Cholangiocarcinoma Patients in Northeastern Thailand after Supportive Treatment

Thunyaharn, Nut; Promthet, Supannee; Wiangnon, Surapon; Suwanrungruang, Krittika; Kamsa‐ard, Supot

doi:10.7314/apjcp.2012.14.11.7029

Cited by 41 publications

(34 citation statements)

References 8 publications

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“…The new classification of advanced stage cholangiocarcinoma by the Mayo clinic group [6] mentioned that the TNM staging system is used to predict the disease outcome, which is mainly based on the histopathological information from the operation. Thus, the TNM staging cannot applied to the patients with ICC because most of them have unresectable disease which is supported by our data and it was similar to previous studies from Thailand [10, 11, 15, 16]. Our study demonstrated that several factors predicted poor survival outcome of hospitalized ICC patients included advanced age >60 years, length of hospital stay of >7 days which related to the more frequency of comorbidities, male, living in the northern part of Thailand, and presence of complications during admission.…”

Section: Discussionsupporting

confidence: 91%

“…The median survival for Thai patients with advanced stages of cholangiocarcinoma was 5–6 months with palliative care [10]. However, cholangiocarcinoma patients with stages 3–4 had a higher mortality rate than those with stages 1–2 by 6.8 folds [11]. Yet there is a lack of data on the burden and outcome of ICC from the country with high prevalence of disease.…”

Section: Introductionmentioning

confidence: 99%

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A significant cancer burden and high mortality of intrahepatic cholangiocarcinoma in Thailand: a nationwide database study

et al. 2017

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BackgroundWe aimed to examine the burden of intrahepatic cholangiocarcinoma (ICC) in Thailand and identify the prognostic factors for all-causes of death.MethodsWe conducted a population-based study of ICC patients admitted during 2009–2013 using the Nationwide Hospital Admission Database, the National Health Security Office (NHSO). There was an average of 1,051,146 patients/year with diagnosis of gastrointestinal diseases (GI). All patients with a diagnosis of ICC (ICD10- C221) were included from a total of 72,479 admissions from 858 hospitals. The surgical resection procedures such as the radical pancreaticoduodenectomy, subtotal and partial hepatectomy were analyzed. Data for all patients were censored 1 year post-study or death, whichever came first.ResultsA total of 34,325 patients with ICC during a 5-year study period (on average, 6865 patients/year, with the incidence rate of 14.6 per 100,000 population, per year. The ICC patients had a mean age of 63.8+/−11.6 years and 63% were males. The mean length of hospital stay was 6.4+/−7.3 days with a mean+/−SD cost of hospitalization of $595+/−$1160 USD per admission. There were 659 patients (1.9%) underwent surgical resection. The overall survival of ICC patients with surgery was significantly better than those patients without surgery. Hazard ratio of death for patients without surgery was 2.5 (95% CI of 2.3–2.7). Approximately 14% of the ICC patients died during hospitalization. The median overall survival of all patients after the first admission was 53 +/−0.6 days. From the multivariate analysis, factors related to all-causes of death were: patients’ age >60 years (OR = 1.2, 95% CI; 1.1–1.3), length of hospital stay of >7 days (OR = 1.1, 95% CI; 1.02–1.2), male (OR = 1.3, 95% CI; 1.2–1.4), living in the northern part of Thailand (OR = 1.5, 95% CI; 1.3–1.8) and presence of complications during admission (OR = 1.3, 95% CI; 1.1–1.5).ConclusionThe disease burden of patients with ICC in Thailand is significant with the incidence rate of 14.6 per 100,000 population, per year during 2009–2013 and showed high mortality rate of 14%.Electronic supplementary materialThe online version of this article (doi:10.1186/s12876-016-0565-6) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

A significant cancer burden and high mortality of intrahepatic cholangiocarcinoma in Thailand: a nationwide database study

et al. 2017

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“…PTCD/ PTBS is a method of biliary tree decompression, applied as palliative treatment in patients with inoperable malignant biliary obstruction, which could not only significantly reduce bilirubin level, improve the patients life quality and prolong survival time, but also provide the possibillity for subsequent treatment (Hatzidakis et al, 2001;Iruarrizaga et al, 2011). In clinical, patients with obstructive jaundice caused by hilar cholangiocarcinoma are common, most of them have lost the chance of operation (Butthongkomvong et al, 2013;Chong et al, 2013;Duangsong et al, 2013;Huang et al, 2013;Hussain et al, 2013;Kamsa-ard et al, 2013;Manwong et al, 2013;Prachayakul et al, 2013;Sriraksa et al, 2013;Srikoon et al, 2013;Sriputtha et al, 2013;Subrungruanga et al, 2013;Thunyaharn et al, 2013;Woradet et al, 2013). Obstructive jaundice caused by hilar cholangiocarcinoma not only affects the patient's liver function, but also influence the patient's survival time.…”

Section: Discussionmentioning

confidence: 99%

Analysis of Different Ways of Drainage for Obstructive Jaundice Caused by Hilar Cholangiocarcinoma

Xu¹,

Lv²,

Huang³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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Objective: To evaluate the prognosis of different ways of drainage for patients with obstructive jaundice caused by hilar cholangiocarcinoma. Materials and Methods: During the period of January 2006-March 2012, percutaneous transhepatic catheter drainage (PTCD)/ percutaneous transhepatic biliary stenting (PTBS) were performed for 89 patients. According to percutaneous transhepatic cholangiography (PTC), external drainage was selected if the region of obstruction could not be passed by guide wire or a metallic stent was inserted if it could. External drainage was the first choice if infection was diagnosed before the procedure, and a metallic stent was inserted in one week after the infection was under control. Selection by new infections, the degree of bilirubin decrease, the change of ALT, the time of recurrence of obstruction, and the survival time of patients as the parameters was conducted to evaluate the methods of different interventional treatments regarding prognosis of patients with hilar obstruction caused by hilar cholangiocarcinoma. Results: PTCD was conducted in 6 patients and PTBS in 7 (p<0.05). Reduction of bilirubin levels and ALT levels was obvious after the procedures (p<0.05). The average survival time with PTCD was 161 days and with PTBS was 243 days (p<0.05). Conclusions: With both drainage procedures for obstructive jaundice caused by hilar cholangiocarcinoma improvement in liver function was obvious. PTBS was found to be better than PTCD for prolonging the patient survival.

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“…It is noteworthy that the liver cancer in O. felineus -infected patients is largely diagnosed as CCA [15,16]. Certainly, the similarity of disease manifestations between the diseases caused by O. felineus and O. viverrini [10,17–19] as well as the results of studies on the pathogenesis of these helminthiases in experimental animal models [20,21], point to fairly high probability of the involvement of O. felineus in the development of CCA. Nonetheless, to date, the biology of O. felineus and its epidemiology and carcinogenic potential have not been studied well, even worse than those of O. viverrini and C. sinensi s. The research into the role of O. felineus in the development of liver cancer in the experimental opisthorchiasis model based on hamsters is one of the first stages in assessment of the carcinogenic potential of this parasite.…”

Section: Introductionmentioning

confidence: 99%

Effect of Opisthorchis felineus infection and dimethylnitrosamine administration on the induction of cholangiocarcinoma in Syrian hamsters

Maksimova

Pakharukova

Кашина

et al. 2017

Parasitology International

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The food-borne liver trematode Opisthorchis felineus is an emerging source of biliary tract diseases on the territory of the former Soviet Union and Eastern Europe. This parasite along with trematodes Opisthorchis viverrini and Clonorchis sinensis belong to the triad of epidemiologically important liver flukes of the Opisthorchiidae family. It is known that O. viverrini and C. sinensis are the main risk factors of cholangiocarcinoma (CCA) in the endemic regions. The carcinogenic potential of O. felineus has not been well researched because of the absence of systematic pathomorphological, clinical, and epidemiological studies on O. felineus opisthorchiasis. In the present study, we show the results of detailed histopathological analysis and comprehensive evaluation of inflammation, bile duct dysplasia, periductal fibrosis, bile duct hyperplasia, bile duct proliferation, egg granuloma, cysts, cholangiofibrosis, and CCA from 10 to 30 weeks following infection of Syrian hamsters with O. felineus accompanied by oral administration of dimethylnitrosamine (DMN). The results revealed that O. felineus contributes to bile duct cancer development in the hamster model. During the combined action of O. felineus and DMN, morphological features of the liver underwent dramatic changes at the cellular and organ levels. Already in the early stages of the experiment, we observed extensive periductal fibrosis, active inflammation, proliferation of the bile duct, bile duct dysplasia and egg granulomas. Later, against the background of all these changes, cholangiofibrosis and CCA were found. Our work is the first step in the study of carcinogenic potential of O. felineus. Obtained data indicate the risk of CCA of patients having chronic O. felineus opisthorchiasis, and underscore the need for the development of programs for control of this helminthiasis.

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Survival of Cholangiocarcinoma Patients in Northeastern Thailand after Supportive Treatment

Cited by 41 publications

References 8 publications

A significant cancer burden and high mortality of intrahepatic cholangiocarcinoma in Thailand: a nationwide database study

A significant cancer burden and high mortality of intrahepatic cholangiocarcinoma in Thailand: a nationwide database study

Analysis of Different Ways of Drainage for Obstructive Jaundice Caused by Hilar Cholangiocarcinoma

Effect of Opisthorchis felineus infection and dimethylnitrosamine administration on the induction of cholangiocarcinoma in Syrian hamsters

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