Cholangiocarcinoma in Italy: 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

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. © 2010 Editrice Gastroenterologica Italiana S.r.l.

Data di pubblicazione: 2011
Titolo: Cholangiocarcinoma in Italy: 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
Autori: Alvaro, Domenico; Bragazzi Maria Consiglia, ; Benedetti, Antonio; Fabris, Luca; Fava, Giammarco; Invernizz, Pietro; Marzioni, Marco; Nuzzo, Gennaro; Strazzabosco, Mario; Stroffolini, Tommaso; Aisf, Wg; Ferretti, S.
Rivista: DIGESTIVE AND LIVER DISEASE
Parole Chiave: Cholangiocarcinoma; Clinical presentation; Diagnosis; Extra-hepatic cholangiocarcinoma; Intra-hepatic cholangiocarcinoma; Risk factors; Treatment; Abdominal Pain; Aged; Bile Duct Neoplasms; Bile Ducts, Extrahepatic; Bile Ducts, Intrahepatic; Cholangiocarcinoma; Cholangiopancreatography, Endoscopic Retrograde; Cholangiopancreatography, Magnetic Resonance; Data Collection; Diarrhea; Fatigue; Female; Hepatitis C; Humans; Italy; Jaundice; Liver Cirrhosis; Male; Middle Aged; Nausea; Tomography, X-Ray Computed; Ultrasonography; Vomiting; Weight Loss; Hepatology; Gastroenterology
Abstract in inglese: 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. © 2010 Editrice Gastroenterologica Italiana S.r.l.
Digital Object Identifier (DOI): 10.1016/j.dld.2010.05.002
Handle: http://hdl.handle.net/11392/2380610
Appare nelle tipologie:03.1 Articolo su rivista

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