Treeprasertsuk Sombat, Poovorawan Kittiyod, Soonthornworasiri Ngamphol, Chaiteerakij Roongruedee, Thanapirom Kessarin, Mairiang Pisaln, Sawadpanich Kookwan, Sonsiri Kanokwan, Mahachai Varocha, Phaosawasdi Kamthorn
Faculty of Medicine, Division of Gastroenterology, Chulalongkorn University, Patumwan, Bangkok, Thailand.
Thai Red Cross, Pathumwan, Bangkok, Thailand.
BMC Gastroenterol. 2017 Jan 5;17(1):3. doi: 10.1186/s12876-016-0565-6.
We aimed to examine the burden of intrahepatic cholangiocarcinoma (ICC) in Thailand and identify the prognostic factors for all-causes of death.
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.
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).
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%.
我们旨在研究泰国肝内胆管癌（ICC）的负担，并确定全因死亡的预后因素。
我们利用国家健康保险办公室（NHSO）的全国医院入院数据库，对2009年至2013年期间收治的ICC患者进行了一项基于人群的研究。每年平均有1,051,146例诊断为胃肠道疾病（GI）的患者。在858家医院的72,479例入院病例中，纳入了所有诊断为ICC（ICD10-C221）的患者。分析了根治性胰十二指肠切除术、肝次全切除术和部分肝切除术等手术切除程序。所有患者的数据在研究后1年或死亡时进行审查，以先到者为准。
在5年的研究期间，共有34,325例ICC患者（平均每年6865例，发病率为每年每10万人14.6例）。ICC患者的平均年龄为63.8±11.6岁，63%为男性。平均住院时间为6.4±7.3天，每次入院的平均住院费用为595±1160美元（标准差）。有659例患者（1.9%）接受了手术切除。接受手术的ICC患者的总生存率明显高于未接受手术的患者。未接受手术患者的死亡风险比为2.5（95%置信区间为2.3-2.7）。约14%的ICC患者在住院期间死亡。首次入院后所有患者的中位总生存期为53±0.6天。多因素分析显示，与全因死亡相关的因素有：患者年龄>60岁（OR=1.2，95%置信区间：1.1-1.3）、住院时间>7天（OR=1.1，95%置信区间：1.02-1.2）、男性（OR=1.3，95%置信区间：1.2-1.4）、居住在泰国北部（OR=1.5，95%置信区间：1.3-1.8）以及入院期间出现并发症（OR=1.3，95%置信区间：1.1-1.5）。
2009年至2013年期间，泰国ICC患者的疾病负担较重，发病率为每年每10万人14.6例，死亡率高达14%。
