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- Title
The Reality Of Cholangiocarcinoma In India: Experience Of Over 500 Patients From Tata Memorial Centre, Mumbai.
- Authors
Kammar, Pravin S.; Shrikhande, Shailesh V.; Goel, Mahesh
- Abstract
Background: Cholangiocarcinoma is a disease with aggressive tumor biology and poor prognosis. Treatment options are limited with surgery still being the most effective treatment. However resectability rates are very low for Cholangiocarcinoma which makes it a disease with dismal prognosis. Methods: All patients diagnosed with intrahepatic cholangiocarcinoma (ICC) and perihilar cholangiocarcinoma (PHCC) who were registered at Tata Memorial Hospital between January 2012 and June 2016 were retrospectively analyzed. Demographic profile, interventions, treatment offered, resectability rates were recorded. Results: A total of 556 patients (331 patients of PHCC, 193 patients of ICC, Mixed 12, others 20) were evaluated at our institution. 21/556 (3.77%) patients did not reach multidisciplinary meetings due to various reasons. After evaluation 50/331 (15.5%) of PHCC and 39/193 (20.2%) patients could not be offered any cancer directed treatment (best supportive care) upfront or within 30 days of treatment. 86 (26%) patients of PHCC and 125(64.7%) ICC patients were metastatic at presentation. PHCC: 32.4% patients did not take offered treatment with lost to follow up being the most common cause (64.58%). 132 (39.8%)patients had resectable disease on imaging. 61 underwent exploration of which 44 were resectable. The overall resectability rate was 13.29% (44/331) ICC: 42 out of 193 (21.76%) patients did not take the offered treatment again loss to follow up being the most common cause. There were 61 cases of localized and locally advanced tumors, 52 of which were amenable for surgery. Out of 52 patients who were deemed resectable, 31 underwent exploration, 23 had curative resection. The overall resectability rate was 12% (23/193) Conclusions: In India, large majority of cholangiocarcinoma patients present at advanced stage or in poor general condition to be unfit to receive any cancer directed treatment and/ or default. Surgery is the most effective treatment but less than 15% of cases can be considered for surgery. Awareness and early referral with centralization only can help in detecting this disease at a stage where treatment can offer a meaningful survival
- Subjects
INDIA; MUMBAI (India); CHOLANGIOCARCINOMA; CANCER treatment; DISEASE progression; PROGNOSIS
- Publication
Journal of Cancer Research & Therapeutics, 2017, Vol 13, pS128
- ISSN
0973-1482
- Publication type
Article