Publication: Ultrasound surveillance for cholangiocarcinoma in an endemic area: A prove of survival benefits
Issued Date
2018-07-01
Resource Type
ISSN
14401746
08159319
08159319
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2-s2.0-85048249768
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Mahidol University
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SCOPUS
Bibliographic Citation
Journal of Gastroenterology and Hepatology (Australia). Vol.33, No.7 (2018), 1383-1388
Suggested Citation
Surachate Siripongsakun, Sirachat Vidhyarkorn, Sirivipa Charuswattanakul, Poemlarp Mekraksakit, Prakongboon Sungkasubun, Nuphat Yodkhunnathum, Sutthirak Tangruangkiat, Napat Ritlumlert, Thaniya Sricharunrat, Sirima Jaroenpatarapesaj, Kamonwan Soonklang, Anond Kulthanmanusorn, Chirayu U. Auewarakul, Chulabhorn Mahidol Ultrasound surveillance for cholangiocarcinoma in an endemic area: A prove of survival benefits. Journal of Gastroenterology and Hepatology (Australia). Vol.33, No.7 (2018), 1383-1388. doi:10.1111/jgh.14074 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/46569
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Title
Ultrasound surveillance for cholangiocarcinoma in an endemic area: A prove of survival benefits
Author(s)
Surachate Siripongsakun
Sirachat Vidhyarkorn
Sirivipa Charuswattanakul
Poemlarp Mekraksakit
Prakongboon Sungkasubun
Nuphat Yodkhunnathum
Sutthirak Tangruangkiat
Napat Ritlumlert
Thaniya Sricharunrat
Sirima Jaroenpatarapesaj
Kamonwan Soonklang
Anond Kulthanmanusorn
Chirayu U. Auewarakul
Chulabhorn Mahidol
Sirachat Vidhyarkorn
Sirivipa Charuswattanakul
Poemlarp Mekraksakit
Prakongboon Sungkasubun
Nuphat Yodkhunnathum
Sutthirak Tangruangkiat
Napat Ritlumlert
Thaniya Sricharunrat
Sirima Jaroenpatarapesaj
Kamonwan Soonklang
Anond Kulthanmanusorn
Chirayu U. Auewarakul
Chulabhorn Mahidol
Abstract
© 2017 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd Background and Aim: Cholangiocarcinoma (CCA) is an aggressive malignancy with rapid progression and poor prognosis. Abdominal ultrasound surveillance may detect early-stage malignancy and improve surgical outcome. However, little data exist on the benefits of abdominal ultrasound surveillance in populations at high risk for CCA development in an endemic area. This study compared survival outcomes of CCA patients recruited through abdominal ultrasound surveillance program and those presented to the hospital independent of surveillance. Methods: The surveillance population-based cohort was 4225 villagers in Northern Thailand, aged 30–60 years, who consented to a 5-year abdominal ultrasound surveillance program, which included interval ultrasound examinations every 6 months. The non-surveillance cohort was hospital-based CCA patients diagnosed during April 2007 to November 2015. Numbers of operable tumors, percentages of R0 resection, and survival analyses were compared between the two cohorts. Results: There were 48 and 192 CCA patients in the surveillance and the non-surveillance cohorts, respectively. Of these, 37/48 (77.1%) and 22/192 (11.5%) were in an operable stage and R0 resections performed in 36/48 (97.3%) and 14/192 (63.6%), respectively. The median survival in each group was 31.8 and 6.7 months, respectively (with correction of lead time bias) (P < 0.0001). By multivariate analysis, abdominal ultrasound surveillance (hazard ratio [HR] = 0.41; P = 0.012), operable stage (HR = 0.11; P < 0.001), and serum albumin ≥ 3.5 g/dL (HR = 0.42; P < 0.001) were significantly associated with decreased mortality, whereas size of CCA (HR = 1.11; P < 0.001), serum alanine aminotransferase > 40 IU/L (HR = 1.71; P = 0.017), and tumor recurrence (HR = 4.86; P = 0.017) were associated with increased mortality. Conclusion: Abdominal ultrasound surveillance provided survival benefits and should be considered in areas highly endemic for CCA to reduce mortality.