PMID- 27914884
OWN - NLM
STAT- MEDLINE
DCOM- 20170217
LR  - 20170217
IS  - 2090-2387 (Electronic)
IS  - 1687-1979 (Linking)
VI  - 17
IP  - 4
DP  - 2016 Dec
TI  - Clinical presentation, diagnosis, and survival in cholangiocarcinoma: A 
      prospective study.
PG  - 181-184
LID - S1687-1979(16)30087-9 [pii]
LID - 10.1016/j.ajg.2016.10.003 [doi]
AB  - BACKGROUND AND STUDY AIMS: The diagnosis of cholangiocarcinoma (CCA) is 
      difficult. The present study aimed to assess the clinical features, diagnosis, 
      and survival in CCA. PATIENTS AND METHODS: This is a prospective study on 46 
      patients with CCA who underwent endoscopic retrograde cholangiopancreatography 
      (ERCP) or surgical resection and 20 controls with a clinical and ERCP suspicion 
      for CCA in whom surgical biopsy and/or 4-year follow-up showed a benign biliary 
      stricture. RESULTS: The median age at presentation was 71years (range 44-88). 
      Thirty-four patients (73.9%) presented with painless jaundice. Median CA 19-9 
      value was 188IU/L (range 1-49,138), with a level of <100IU/L in 13 patients 
      (28%). Total bilirubin was 11.9 (0.6-36.3)mg/dL. The tumour was intrahepatic in 3 
      (6.5%), hilar (Klatskin) in 25 (54.3%), and located in the lower third of the 
      bile duct in 18 (39.1%) patients. The diagnosis was confirmed by positive 
      cytology in 10 (21.7%), biopsy in 20 (43.5%), cholangioscopy in five (10.9%), and 
      imaging and clinical grounds in 11 (23.9%) patients. Cytology was feasible in 36 
      patients; it was positive in 10 and "highly indicative" in two patients (33.3% 
      sensitivity). Twenty-two patients (47.8%) were treated by surgical resection, and 
      the rest were offered palliative biliary drainage. Mean estimated survival for 
      the entire group of CCA patients was 21.5+/-3.3months. Survival was slightly longer 
      in patients who underwent surgical resection than those who had palliative 
      treatment; the estimated mean survival rates were 26.2+/-4.2 vs. 17.1+/-3.3months, 
      respectively, but the difference was not statistically significant (p=0.115). 
      CONCLUSION: The diagnosis of CCA is difficult and often delayed. The outcome is 
      generally poor.
CI  - Copyright (c) 2016 Pan-Arab Association of Gastroenterology. Published by Elsevier 
      B.V. All rights reserved.
FAU - Vasilieva, Larisa
AU  - Vasilieva L
AD  - 2nd Department of Internal Medicine, "Hippokration" Hospital, Medical School, 
      National and Kapodistrian University of Athens, Athens 11527, Greece.
FAU - Papadhimitriou, Stefanos I
AU  - Papadhimitriou SI
AD  - Hematology Laboratory, "G. Gennimatas" General Hospital, Athens 11527, Greece.
FAU - Alexopoulou, Alexandra
AU  - Alexopoulou A
AD  - 2nd Department of Internal Medicine, "Hippokration" Hospital, Medical School, 
      National and Kapodistrian University of Athens, Athens 11527, Greece.
FAU - Kostopoulos, Ioannis
AU  - Kostopoulos I
AD  - 2nd Department of Internal Medicine, "Hippokration" Hospital, Medical School, 
      National and Kapodistrian University of Athens, Athens 11527, Greece.
FAU - Papiris, Konstantinos
AU  - Papiris K
AD  - Endoscopic Surgery Unit, Hippokration Hospital, Athens 11527, Greece.
FAU - Pavlidis, Dimitrios
AU  - Pavlidis D
AD  - Hematology Laboratory, "G. Gennimatas" General Hospital, Athens 11527, Greece.
FAU - Xinopoulos, Dimitrios
AU  - Xinopoulos D
AD  - Gastroenterology Unit, "Agios Savvas" Cancer Hospital, Athens 11521, Greece.
FAU - Romanos, Andreas
AU  - Romanos A
AD  - Endoscopic Surgery Unit, Hippokration Hospital, Athens 11527, Greece.
FAU - Dourakis, Spyridon P
AU  - Dourakis SP
AD  - 2nd Department of Internal Medicine, "Hippokration" Hospital, Medical School, 
      National and Kapodistrian University of Athens, Athens 11527, Greece. Electronic 
      address: spdour@med.uoa.gr.
LA  - eng
PT  - Journal Article
DEP - 20161130
PL  - Egypt
TA  - Arab J Gastroenterol
JT  - Arab journal of gastroenterology : the official publication of the Pan-Arab 
      Association of Gastroenterology
JID - 101298363
RN  - 0 (CA-19-9 Antigen)
RN  - EC 2.6.1.1 (Aspartate Aminotransferases)
RN  - EC 3.1.3.1 (Alkaline Phosphatase)
RN  - RFM9X3LJ49 (Bilirubin)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Alkaline Phosphatase/blood
MH  - Aspartate Aminotransferases/blood
MH  - Bile Duct Neoplasms/blood/diagnostic imaging/*pathology/*surgery
MH  - Bile Ducts, Extrahepatic/*pathology
MH  - Bile Ducts, Intrahepatic/*pathology
MH  - Bilirubin/blood
MH  - Biopsy
MH  - CA-19-9 Antigen/blood
MH  - Cholangiopancreatography, Endoscopic Retrograde
MH  - Constriction, Pathologic/blood/diagnostic imaging/pathology
MH  - Drainage
MH  - Female
MH  - Humans
MH  - Jaundice/etiology
MH  - Klatskin Tumor/blood/diagnostic imaging/*pathology/*surgery
MH  - Male
MH  - Middle Aged
MH  - *Palliative Care
MH  - Prospective Studies
MH  - Survival Rate
OTO - NOTNLM
OT  - Cholangiocarcinoma
OT  - Klatskin tumour
OT  - Mortality
EDAT- 2016/12/05 06:00
MHDA- 2017/02/18 06:00
CRDT- 2016/12/05 06:00
PHST- 2016/01/06 00:00 [received]
PHST- 2016/08/24 00:00 [revised]
PHST- 2016/10/31 00:00 [accepted]
PHST- 2016/12/05 06:00 [pubmed]
PHST- 2017/02/18 06:00 [medline]
PHST- 2016/12/05 06:00 [entrez]
AID - S1687-1979(16)30087-9 [pii]
AID - 10.1016/j.ajg.2016.10.003 [doi]
PST - ppublish
SO  - Arab J Gastroenterol. 2016 Dec;17(4):181-184. doi: 10.1016/j.ajg.2016.10.003. 
      Epub 2016 Nov 30.