Clinical Characteristics and Treatment Outcomes of Patients with Unresectable Cholangiocarcinoma in Thailand: Are there Differences Dependent on Stent Type?

Prachayakul, Varayu; Chaisayan, Suthasinee; Aswakul, Pitulak; Deesomsak, Morakod

doi:10.7314/apjcp.2013.14.1.529

Cited by 5 publications

(7 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…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

View full text Add to dashboard Cite

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.

show abstract

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

View full text Add to dashboard Cite

show abstract

“…Additionally, ICC is associated with a high rate of fatality because of its nature of early invasion, widespread metastasis, and lack of effective treatment [9]. 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].…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2017

View full text Add to dashboard Cite

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.

show abstract

“…The patency of SEMS and plastic stents in hilar cholangiocarcinoma were previously reported in many studies as 3.4-5.5 months and 1.2-1.86 months, respectively [21,36] . A meta-analysis by Hong et al [37,38] Sangchan et al [36] reported a model based on a cost utility analysis and demonstrated that SEMS is more cost effective than plastic stents, while the median survival time of SEMS and plastic stents in this study was 129 and 49 days, respectively.…”

Section: Should Plastic Stents or Self-expandable Metal Stents (Sems)mentioning

confidence: 99%

“…CCA is classified into extrahepatic and intrahepatic types, the ratios of which vary 0.2-187:1 [2,21,22]. Hilar CCA, an extrahepatic type, was classified by Bismuth and Corlette [23] in 1975 into four subtypes ( Figure 1).…”

Section: Unresectable Cholangiocarcinomamentioning

confidence: 99%

“…Despite the fact that the prognosis of patients with advanced or unresectable cholangiocarcinoma is poor with a median survival time of <6 months [21], it is necessary to ensure a good quality of life and limit the tumor invasion. In this article, we review the endoscopic treatments and techniques in terms of endoscopic biliary drainage and intraluminal procedures for locoregional tumor control that are beneficial for patients with CCA.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Current Status of Endoscopic Treatment of Advanced Hilar Cholangiocarcinoma

Prachayakul¹

2014

J Gastroint Dig Syst

Self Cite

View full text Add to dashboard Cite

Cholangiocarcinoma is a high-mortality primary hepatic malignancy. A higher incidence of cholangiocarcinoma was reported in Asia, especially Southeast Asia, than in Western countries. Hilar cholangiocarcinoma is a specific type of extrahepatic cholangiocarcinoma that involves the hepatic hilum and has a worse prognosis. More than half of the patients with jaundice are inoperable at the time of first diagnosis. Therefore, biliary drainage is the mainstay of palliative treatment in these patients. Endoscopic biliary drainage via endoscopic retrograde cholangiopancreatography, the modality of choice, for the advanced hilar type is more difficult and complex than those in distal cholangiocarcinoma. Endoscopists should consider many factors before selecting the most appropriate treatment for each patient. Here we discuss the factors systematically. In cases of transpapillary approach failure, other therapeutic modalities should be considered. Percutaneous transhepatic biliary drainage is the most popular method in such cases. At the present, endoscopic ultrasound-guided biliary drainage, especially hepaticogastrostomy, is an alternative procedure with the same efficacy and low complications when it was carried out in the expert hands. Furthermore, recent locoregional therapies for tumor control including trans-luminal photodynamic therapy and radiofrequency ablation also benefit these patients.

show abstract

Clinical Characteristics and Treatment Outcomes of Patients with Unresectable Cholangiocarcinoma in Thailand: Are there Differences Dependent on Stent Type?

Cited by 5 publications

References 16 publications

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

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

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

Current Status of Endoscopic Treatment of Advanced Hilar Cholangiocarcinoma

Contact Info

Product

Resources

About