Observational Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Oct 21, 2017; 23(39): 7160-7167
Published online Oct 21, 2017. doi: 10.3748/wjg.v23.i39.7160
Characteristics and outcomes of cholangiocarcinoma by region in Thailand: A nationwide study
Roongruedee Chaiteerakij, Wirichada Pan-ngum, Kittiyod Poovorawan, Ngamphol Soonthornworasiri, Sombat Treeprasertsuk, Kamthorn Phaosawasdi
Roongruedee Chaiteerakij, Sombat Treeprasertsuk, Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, and King Chulalongkorn Memorial Hospital, Bangkok 10330, Thailand
Wirichada Pan-ngum, Ngamphol Soonthornworasiri, Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
Kittiyod Poovorawan, Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
Kamthorn Phaosawasdi, Vichaiyut Hospital and Medical Center, Bangkok 10400, Thailand
Author contributions: Chaiteerakij R, Pan-ngum W, Poovorawan K, Soonthornworasiri N, Treeprasertsuk S and Phaosawasdi K contributed to the study conception and design; Chaiteerakij R, Pan-ngum W, Poovorawan K and Soonthornworasiri N contributed to data acquisition, data analysis and interpretation; Chaiteerakij R contributed to the writing of the article; Chaiteerakij R, Pan-ngum W, Poovorawan K, Soonthornworasiri N, Treeprasertsuk S and Phaosawasdi K contributed to the editing, reviewing and final approval of the article.
Supported by Gastroenterological Association of Thailand (GAT), the Division of Gastroenterology, Department of Medicine, Chulalongkorn University; and the Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Institutional review board statement: This study was approved by the Institutional Review Board of the Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand (IRB no. 113/58). The certificate from the Institutional Review Board was provided accordingly.
Informed consent statement: The patients’ information in the database was de-identified before the investigator accessed the data.
Conflict-of-interest statement: The authors hereby declare no personal or professional conflicts of interest regarding any aspects of this study.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Roongruedee Chaiteerakij, MD, PhD, Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, and King Chulalongkorn Memorial Hospital, 1873 Rama IV Road, Pathumwan, Bangkok 10330, Thailand. roongruedee.c@chula.ac.th
Telephone: +66-2-2564356 Fax: +66-2-2527839
Received: June 29, 2017
Peer-review started: June 30, 2017
First decision: July 27, 2017
Revised: September 21, 2017
Accepted: September 29, 2017
Article in press: September 28, 2017
Published online: October 21, 2017
Processing time: 114 Days and 22.6 Hours
Abstract
AIM

To identify the potential risk factors of cholangiocarcinoma, we determined the characteristics of cholangiocarcinoma patients among 5 different regions of Thailand.

METHODS

All patients diagnosed with cholangiocarcinoma between 2008 and 2013 were identified using the Nationwide Hospital Admission Data registry (n = 39421). Baseline characteristics, comorbidities and survival were abstracted.

RESULTS

The annual incidence during the study period was stable in all regions. Most patients lived in the Northeast (62.8%), followed by the North (16.9%), Central (12.3%), Bangkok (5.4%), and South (n = 2.6%) regions (P < 0.0001). Significantly more cholangiocarcinoma patients had diabetes, cirrhosis, and chronic viral hepatitis B/C infection than non-cholangiocarcinoma participants (diabetes: 11.42% vs 5.28%; cirrhosis: 4.81% vs 0.92%; hepatitis B: 0.74% vs 0.12%; and hepatitis C: 0.50% vs 0.10%, P < 0.0001 for all, respectively). The overall 1-year mortality rate was 81.7%, with a stable trend over time.

CONCLUSION

Diabetes and chronic liver diseases may be associated with cholangiocarcinoma in the Thai population.

Keywords: Bile duct cancer; Population-based study; Epidemiology; Liver fluke infection

Core tip: Cholangiocarcinoma is highly prevalent in Thailand, particularly in the Northeast region. The high cholangiocarcinoma incidence in this region is known to be associated with a high prevalence of liver fluke infection. Cirrhosis, diabetes, and chronic viral hepatitis B and C infections have been recently identified as risk factors for cholangiocarcinoma in Western countries. In this study, we found that diabetes and chronic liver diseases may be associated with cholangiocarcinoma in the Thai population. Further study to determine the magnitude of the impact of these factors on cholangiocarcinoma development in the Thai population is necessary.