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. 2017 Jan 5;17(1):3.
doi: 10.1186/s12876-016-0565-6.

A significant cancer burden and high mortality of intrahepatic cholangiocarcinoma in Thailand: a nationwide database study

Sombat Treeprasertsuk  1   2   3 , Kittiyod Poovorawan  4 , Ngamphol Soonthornworasiri  5 , Roongruedee Chaiteerakij  6   7 , Kessarin Thanapirom  6   7 , Pisaln Mairiang  8 , Kookwan Sawadpanich  8 , Kanokwan Sonsiri  7 , Varocha Mahachai  6 , Kamthorn Phaosawasdi  9
Affiliations

A significant cancer burden and high mortality of intrahepatic cholangiocarcinoma in Thailand: a nationwide database study

Sombat Treeprasertsuk et al. BMC Gastroenterol. .

Abstract

Background: We aimed to examine the burden of intrahepatic cholangiocarcinoma (ICC) in Thailand and identify the prognostic factors for all-causes of death.

Methods: We conducted a population-based study of ICC patients admitted during 2009-2013 using the Nationwide Hospital Admission Database, the National Health Security Office (NHSO). There was an average of 1,051,146 patients/year with diagnosis of gastrointestinal diseases (GI). All patients with a diagnosis of ICC (ICD10- C221) were included from a total of 72,479 admissions from 858 hospitals. The surgical resection procedures such as the radical pancreaticoduodenectomy, subtotal and partial hepatectomy were analyzed. Data for all patients were censored 1 year post-study or death, whichever came first.

Results: A total of 34,325 patients with ICC during a 5-year study period (on average, 6865 patients/year, with the incidence rate of 14.6 per 100,000 population, per year. The ICC patients had a mean age of 63.8+/-11.6 years and 63% were males. The mean length of hospital stay was 6.4+/-7.3 days with a mean+/-SD cost of hospitalization of $595+/-$1160 USD per admission. There were 659 patients (1.9%) underwent surgical resection. The overall survival of ICC patients with surgery was significantly better than those patients without surgery. Hazard ratio of death for patients without surgery was 2.5 (95% CI of 2.3-2.7). Approximately 14% of the ICC patients died during hospitalization. The median overall survival of all patients after the first admission was 53 +/-0.6 days. From the multivariate analysis, factors related to all-causes of death were: patients' age >60 years (OR = 1.2, 95% CI; 1.1-1.3), length of hospital stay of >7 days (OR = 1.1, 95% CI; 1.02-1.2), male (OR = 1.3, 95% CI; 1.2-1.4), living in the northern part of Thailand (OR = 1.5, 95% CI; 1.3-1.8) and presence of complications during admission (OR = 1.3, 95% CI; 1.1-1.5).

Conclusion: The disease burden of patients with ICC in Thailand is significant with the incidence rate of 14.6 per 100,000 population, per year during 2009-2013 and showed high mortality rate of 14%.

Keywords: Cancer burden; Intrahepatic cholangiocarcinoma; Nationwide database; Thailand.

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Figures

Fig. 1
Fig. 1
Mean overall survival of all patients with intrahepatic cholangiocarcinoma after first admission
Fig. 2
Fig. 2
Mean overall survival for all patients with intrahepatic cholangiocarcinoma with surgery compared to those without surgery
See this image and copyright information in PMC

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