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

Domenico Alvaro, Maria Consiglia Bragazzi, Antonio Benedetti, Luca Fabris, Giammarco Fava, Pietro Invernizzi, Marco Marzioni, Gennaro Nuzzo, Mario Strazzabosco, Tommaso Stroffolini

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)60-65
Number of pages6
JournalDigestive and Liver Disease
Volume43
Issue number1
DOIs
StatePublished - Jan 2011
Externally publishedYes

Fingerprint

Cholangiocarcinoma
Italy
Liver Diseases
Liver
Surveys and Questionnaires
Fibrosis
Jaundice

Keywords

  • Cholangiocarcinoma
  • Clinical presentation
  • Diagnosis
  • Extra-hepatic cholangiocarcinoma
  • Intra-hepatic cholangiocarcinoma
  • Risk factors
  • Treatment

ASJC Scopus subject areas

  • Gastroenterology
  • Hepatology

Cite this

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. / Alvaro, Domenico; Bragazzi, Maria Consiglia; Benedetti, Antonio; Fabris, Luca; Fava, Giammarco; Invernizzi, Pietro; Marzioni, Marco; Nuzzo, Gennaro; Strazzabosco, Mario; Stroffolini, Tommaso.

In: Digestive and Liver Disease, Vol. 43, No. 1, 01.2011, p. 60-65.

Research output: Contribution to journalArticle

Alvaro, Domenico ; Bragazzi, Maria Consiglia ; Benedetti, Antonio ; Fabris, Luca ; Fava, Giammarco ; Invernizzi, Pietro ; Marzioni, Marco ; Nuzzo, Gennaro ; Strazzabosco, Mario ; Stroffolini, Tommaso. / 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. In: Digestive and Liver Disease. 2011 ; Vol. 43, No. 1. pp. 60-65.
@article{6d87fd08cddd40a6b421d047d83ff47e,
title = "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",
abstract = "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.",
keywords = "Cholangiocarcinoma, Clinical presentation, Diagnosis, Extra-hepatic cholangiocarcinoma, Intra-hepatic cholangiocarcinoma, Risk factors, Treatment",
author = "Domenico Alvaro and Bragazzi, {Maria Consiglia} and Antonio Benedetti and Luca Fabris and Giammarco Fava and Pietro Invernizzi and Marco Marzioni and Gennaro Nuzzo and Mario Strazzabosco and Tommaso Stroffolini",
year = "2011",
month = "1",
doi = "10.1016/j.dld.2010.05.002",
language = "English (US)",
volume = "43",
pages = "60--65",
journal = "Digestive and Liver Disease",
issn = "1590-8658",
publisher = "Elsevier",
number = "1",

}

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

UR - http://www.scopus.com/inward/record.url?scp=78649971678&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=78649971678&partnerID=8YFLogxK

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 -