TY - JOUR
T1 - Cholangiocarcinoma in Italy
T2 - A national survey on clinical characteristics, diagnostic modalities and treatment. Results from the " Cholangiocarcinoma" committee of the Italian Association for the Study of Liver disease
AU - Alvaro, Domenico
AU - Bragazzi, Maria Consiglia
AU - Benedetti, Antonio
AU - Fabris, Luca
AU - Fava, Giammarco
AU - Invernizzi, Pietro
AU - Marzioni, Marco
AU - Nuzzo, Gennaro
AU - Strazzabosco, Mario
AU - Stroffolini, Tommaso
PY - 2011/1
Y1 - 2011/1
N2 - Background: Very few studies assessed cholangiocarcinoma clinical characteristics. Aim: To evaluate the clinical characteristics of intra-hepatic (IH) and extra-hepatic (EH)-CCA. Methods: We performed a national survey based on a questionnaire. Results: 218 cholangiocarcinomas were observed (47% EH-CCA, 53% IH-CCA) with an age at the diagnosis higher for EH-CCA. Coexistence of cirrhosis or viral cirrhosis was more frequent in IH-CCA than EH-CCA. An incidental asymptomatic presentation occurred in 28% of IH-CCA vs 4% EH-CCA whilst, 74% EH-CCA vs 28% IH-CCA presented with jaundice. 91% of IH-CCA presented as a single intra-hepatic mass, whilst 50% of EH-CCA was peri-hilar. In the diagnostic work-up, 70% of all cholangiocarcinoma cases received at least 3 different imaging procedures. Tissue-proven diagnosis was obtained in 80% cholangiocarcinoma. Open surgery with curative intent was performed in 45% of IH-CCA and 29% EH-CCA. 18% IH-CCA vs 4% EH-CCA did not received treatment. Conclusions: In Italy IH-CCA is managed as frequently as EH-CCA. In comparison to EH-CCA, IH-CCA occurs at younger age and is more frequently associated with cirrhosis and with an incidental asymptomatic presentation. In contrast, most EH-CCAs are jaundiced at the diagnosis. Cholangiocarcinoma diagnostic management is cost- and time-consuming with curative surgical treatment applicable more frequently in IH-CCA.
AB - Background: Very few studies assessed cholangiocarcinoma clinical characteristics. Aim: To evaluate the clinical characteristics of intra-hepatic (IH) and extra-hepatic (EH)-CCA. Methods: We performed a national survey based on a questionnaire. Results: 218 cholangiocarcinomas were observed (47% EH-CCA, 53% IH-CCA) with an age at the diagnosis higher for EH-CCA. Coexistence of cirrhosis or viral cirrhosis was more frequent in IH-CCA than EH-CCA. An incidental asymptomatic presentation occurred in 28% of IH-CCA vs 4% EH-CCA whilst, 74% EH-CCA vs 28% IH-CCA presented with jaundice. 91% of IH-CCA presented as a single intra-hepatic mass, whilst 50% of EH-CCA was peri-hilar. In the diagnostic work-up, 70% of all cholangiocarcinoma cases received at least 3 different imaging procedures. Tissue-proven diagnosis was obtained in 80% cholangiocarcinoma. Open surgery with curative intent was performed in 45% of IH-CCA and 29% EH-CCA. 18% IH-CCA vs 4% EH-CCA did not received treatment. Conclusions: In Italy IH-CCA is managed as frequently as EH-CCA. In comparison to EH-CCA, IH-CCA occurs at younger age and is more frequently associated with cirrhosis and with an incidental asymptomatic presentation. In contrast, most EH-CCAs are jaundiced at the diagnosis. Cholangiocarcinoma diagnostic management is cost- and time-consuming with curative surgical treatment applicable more frequently in IH-CCA.
KW - Cholangiocarcinoma
KW - Clinical presentation
KW - Diagnosis
KW - Extra-hepatic cholangiocarcinoma
KW - Intra-hepatic cholangiocarcinoma
KW - Risk factors
KW - Treatment
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U2 - 10.1016/j.dld.2010.05.002
DO - 10.1016/j.dld.2010.05.002
M3 - Article
C2 - 20580332
AN - SCOPUS:78649971678
VL - 43
SP - 60
EP - 65
JO - Digestive and Liver Disease
JF - Digestive and Liver Disease
SN - 1590-8658
IS - 1
ER -