Managed Care Weekly Digest

New findings reported from Baylor College of Medicine, College of Medicine describe advances in cholangio cancer

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"Using data from the Surveillance, Epidemiology, and End-Results-(SEER) Medicare database, we compared ICC patients receiving different therapies between 1992 and 1999. Univariate and multivariate analyses were performed and adjusted odds ratios (AORs) were calculated. Hazard ratios were calculated for the survival analysis. Eight hundred sixty-two cases were included. The mean age at diagnosis was 77.9 years (SD = 7. 1). Only 6.3 % received surgical resection, 65.5% received palliative interventions (16.1 % surgical, 44.0% endoscopic), 24.4% received only chemo or radiation therapy whereas 3.8% did not receive any treatment. The median survival was 708 days [95% confidence interval (CI): 458-945] for surgical resection, 227 days (95% CI: 182-294) for surgical palliation, and 123 days (95% CI: 108-148) for endoscopic palliation. Patients receiving surgical resection were younger (AOR = 5.6, 95% CI: 2.9-11. 1), more likely to be diagnosed later in the study period (AOR 2.2, 95% CI: 1.1-4.2), and had better mortality (hazard ratio 0.3, 95% CI: 0.2-0.4). Patients receiving surgical palliation were younger (AOR = 1.6, 95% CI: 1.1-2.3), more likely to be diagnosed in the early time period (AOR = 1.5, 95% CI: 1.1-2.2), and had similar mortality to those receiving endoscopic palliation. Only a minority of patients with ICC receives potentially curative therapy. Young age is the strongest predictor of receiving potentially curative treatment. Older patients and those diagnosed in recent time periods are more likely to receive endoscopic palliation. Surgical resection was associated with improved survival," wrote Y.H. Shaib and colleagues, Baylor College of Medicine, College of Medicine.

The researchers concluded: "There was no difference in survival between surgical and endoscopic palliation."

Shaib and colleagues published their study in the Journal of Clinical Gastroenterology (Endoscopic and surgical therapy for intrahepatic Cholangiocarcinoma in the united states - A population-based study. Journal of Clinical Gastroenterology, 2007;41(10):911-917).

For additional information, contact Y.H. Shaib, Baylor College of Medicine, Sect Health Service Research, Houston Vet. Affairs Med Center, National Institutes of Health, DHHS, Bethesda, MD, USA.

Publisher contact information for the Journal of Clinical Gastroenterology is: Lippincott Williams & Wilkins, 530 Walnut St., Philadelphia, PA 19106-3621, USA.

Keywords: United States, Bethesda, Cholangio Cancer, Cholangio Carcinoma, Clinical Gastroenterology, Epidemiology, Gastroenterology, Health Policy, Medicare, Oncology, Radiation Therapy, Treatment, Baylor College of Medicine, College of Medicine.

This article was prepared by Managed Care Weekly Digest editors from staff and other reports. Copyright 2008, Managed Care Weekly Digest via NewsRx.com.