Main causes of death in advanced biliary tract cancer

Kimura‐Seto, Kana; Kojima, Yasushi; Komori, Shiori; Hisada, Yuya; Otake, Yuki; Yanai, Yuka; Saito, Akiko; Akazawa, Naoki; Tanaka, Yasuo; Yokoi, Chizu; Yanase, Mikio; Akiyama, Junichi; Yamamoto, Natsuyo; Yamada, Kazuhiko

doi:10.1002/cam4.5794

Cited by 3 publications

(1 citation statement)

References 21 publications

(31 reference statements)

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“…Antibiotic therapy is administered until fever and septicemia subside. Cholangitis occurs in approximately 30.6% of cases in patients with biliary tract cancer [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

Cholangiocarcinoma of the Common Bile Duct Presenting as Empyema of the Gallbladder: A Rare Case Report

Khaladkar,

Jhala,

Dhande

et al. 2024

Cureus

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Cholangiocarcinoma of the common bile duct (CBD) presenting as empyema of the gallbladder is a rare entity that poses a risk of septicemia, septic shock, peritonitis, and abscess formation. This case report describes an elderly female presenting with pain in the right hypochondrium, a positive Murphy's sign, and a history of regurgitation and constipation. It highlights the value of imaging in the early diagnosis of this rare presentation of underlying malignancy. The most common cause of empyema of the gallbladder is acute cholecystitis, followed by gallbladder neck obstruction by a calculus. This report discusses the important role of imaging supported by clinical history, examination, laboratory tests, and histopathological findings to diagnose this rare presentation of empyema of the gallbladder as a complication of underlying cholangiocarcinoma. Additionally, it briefly discusses the change in the management line for cholangiocarcinoma patients with complications such as gallbladder perforation and septicemia. The study concludes that the possibility of underlying bile duct malignancy cannot be overlooked in patients with similar symptoms, particularly among the elderly.

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“…Antibiotic therapy is administered until fever and septicemia subside. Cholangitis occurs in approximately 30.6% of cases in patients with biliary tract cancer [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

Cholangiocarcinoma of the Common Bile Duct Presenting as Empyema of the Gallbladder: A Rare Case Report

Khaladkar,

Jhala,

Dhande

et al. 2024

Cureus

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Main causes of death in advanced biliary tract cancer

et al. 2023

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Background There are no previous reports on the main causes of death in biliary tract cancer (BTC) patients. This study aimed to evaluate the main causes of death and survival rates in patients with BTC. Methods We retrospectively evaluated 143 patients who were diagnosed with unresectable BTC between August 2010 and March 2020. We classified the main causes of death based on laboratory data, imaging studies, and medical records. The main causes of death evaluated included liver failure, cholangitis, cachexia, other causes associated with tumor progression, and complications. We also analyzed survival rates for each main cause of death. Results After excluding patients who were lost to follow‐up, living patients, and patients who had no records of laboratory data within 30 days before the date of death, 108 patients were analyzed. The main cause of death was cholangitis in 33 (30.6%), cachexia in 22 (20.4%), liver failure in 10 (9.3%), other causes associated with tumor progression in 18 (16.7%), and complications in 25 (23.2%) patients. Median overall survival (OS) was 334.0 days in the chemotherapy group and 75.0 days in the best supportive care (BSC) group. Survival analyzed according to the main cause of death was significantly different between the chemotherapy and BSC groups; OS for cachexia, cholangitis, liver failure, other causes associated with tumor progression, and complications, respectively, were 453.0, 499.0, 567.0, 205.0, and 327.5 days (p = 0.003) in the chemotherapy group and 219.0, 69.0, 34.0, 93.0, and 56.0 days (p = 0.001) in the BSC group. Conclusion The main causes of death in patients with advanced BTC are cholangitis, cachexia, liver failure, other causes associated with tumor progression, and complications. Other causes associated with tumor progression in the chemotherapy group, and liver failure in the BSC group as the main causes of death shortened the survival of BTC patients.

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Real‐world evidence of systemic treatment practices for biliary tract cancer in Japan: Results of a database study

Ueno,

Shirakawa,

Tokumaru

et al. 2024

J Hepato Biliary Pancreat

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PurposeTo describe the real‐world treatment patterns of systemic therapies for biliary tract cancer (BTC) and to examine the frequency and management of biliary infection in Japan.MethodsPatients diagnosed with BTC and prescribed systemic therapy between January 2011 and September 2020 were retrieved from the Japanese Medical Data Vision database. The look‐back period was set to 5 years. Patient characteristics, treatment patterns, and biliary infection‐induced treatment interruption were analyzed.ResultsThe full analysis set comprised 22 742 patients with a mean age of 71.0 years and 61.6% were male. The most common BTC type was extrahepatic cholangiocarcinoma (44.6%). The three most common first‐line regimens were S‐1 monotherapy (33.0%), gemcitabine+cisplatin (32.5%), and gemcitabine monotherapy (18.7%) over the entire observation period (January 2011–September 2021). Patients who received monotherapies tended to be older. Biliary infection‐induced treatment interruption occurred in 29.5% of patients, with a median time to onset of 64.0 (interquartile range 29.0–145.0) days. The median duration of intravenous antibiotics was 12.0 (interquartile range 4.0–92.0) days.ConclusionsThese results demonstrated potential challenges of BTC in Japanese clinical practice particularly use of multiple regimens, commonly monotherapies, which are not recommended as first‐line treatment, and the management of biliary infections during systemic therapy.

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Main causes of death in advanced biliary tract cancer

Cited by 3 publications

References 21 publications

Cholangiocarcinoma of the Common Bile Duct Presenting as Empyema of the Gallbladder: A Rare Case Report

Cholangiocarcinoma of the Common Bile Duct Presenting as Empyema of the Gallbladder: A Rare Case Report

Main causes of death in advanced biliary tract cancer

Real‐world evidence of systemic treatment practices for biliary tract cancer in Japan: Results of a database study

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