Abstract:
BACKGROUND:Intrahepatic cholangiocarcinoma (ICC) is a highly fatal disease with limited therapeutic options. The determinants, trends, and outcomes of different therapies for ICC are largely unknown in the United States. METHODS: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. RESULTS: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. CONCLUSIONS: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. There was no difference in survival between surgical and endoscopic palliation.
journal_name
J Clin Gastroenteroljournal_title
Journal of clinical gastroenterologyauthors
Shaib YH,Davila JA,Henderson L,McGlynn KA,El-Serag HBdoi
10.1097/MCG.0b013e31802f3132subject
Has Abstractpub_date
2007-11-01 00:00:00pages
911-7issue
10eissn
0192-0790issn
1539-2031pii
00004836-200711000-00008journal_volume
41pub_type
杂志文章abstract:GOALS:To evaluate clinical, biochemical, and radiologic parameters at admission, which predict the development of acute pseudocyst (AP) after acute pancreatitis. BACKGROUND:There is limited data on factors that predict the development of AP. STUDY:Seventy-five consecutive patients with AP were prospectively enrolled ...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
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abstract::Aspirin is commonly accepted as a risk factor for gastric ulcer; however, there is little published evidence linking aspirin consumption to duodenal ulcer. The effect of 1 g of aspirin per day on site-specific ulcer hospitalizations was examined using data from a 3-year randomized, double-blind, placebo-controlled tri...
journal_title:Journal of clinical gastroenterology
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1990-06-01 00:00:00
abstract::Total colonoscopy was performed in 38 consecutive cirrhotics (15 alcoholic, 19 postviral, four unknown) with portal hypertension, 32 of whom were enrolled in a program of esophageal sclerotherapy because of variceal bleeding (Child's grading: A, 13; B, 21; C, 4 patients). In 34 of them, multiple biopsies from the colo...
journal_title:Journal of clinical gastroenterology
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doi:10.1097/00004836-199406000-00014
更新日期:1994-06-01 00:00:00
abstract::A 2-year-old boy presented with sexual precocity secondary to a hormone-producing hepatoblastoma. The tumor demonstrated an aggressive histologic pattern and stained immunohistochemically for alpha-fetoprotein and beta-subunit human chorionic gonadotrophin. After a successful liver transplant these tumor markers were ...
journal_title:Journal of clinical gastroenterology
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更新日期:1987-02-01 00:00:00
abstract::We identified spontaneous reactivation of hepatitis B virus (HBV) retrospectively by utilizing serum alanine aminotransferase and HBV DNA in 19 men (79% homosexual), with an estimated annual incidence of 7.3%. In 11 patients, spontaneous reactivation occurred as a single episode and in eight patients, reactivation was...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-199010000-00015
更新日期:1990-10-01 00:00:00
abstract::The practice of gastroenterology is undergoing sweeping changes that demand improvements in efficiency and effectiveness within the practice and ambulatory endoscopy centers. This article discusses core principles of practice and endoscopic ambulatory surgery center function and management that lead to the improvement...
journal_title:Journal of clinical gastroenterology
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doi:10.1097/MCG.0b013e318046ef80
更新日期:2007-04-01 00:00:00
abstract:BACKGROUND:The presence of laryngopharyngeal reflux disease is controversial when abnormal sensation of the laryngopharynx is felt without heartburn. GOALS:The aims of this study were to investigate the relationship between abnormal sensation of the laryngopharynx and gastroesophageal reflux, and to elucidate the path...
journal_title:Journal of clinical gastroenterology
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abstract:BACKGROUND AND AIM:Nonalcoholic fatty liver disease (NAFLD) is one of the most common causes of chronic liver disease. The objective of this study was to describe the recent trend of health care resource utilization and short-term mortality of Medicare beneficiaries with NAFLD. METHODS:This study utilized data from a ...
journal_title:Journal of clinical gastroenterology
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abstract:GOAL:To prospectively assess the utility of multidetector row computed tomography angiography (MDCTA) in the diagnosis of active gastrointestinal bleeding (GIB). BACKGROUND:MDCTA is a relatively recent advance in CT scanning technology enabling excellent vascular visualization and detection of various vascular abnorma...
journal_title:Journal of clinical gastroenterology
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更新日期:2012-01-01 00:00:00
abstract::Endoscopic placement of nasoenteric feeding tubes is a common technique used in clinical practice. However, use of the endoscopic "drag and pull" method to pull the tube into position by grasping the feeding tube with a biopsy forceps requires considerable skill. In this paper, we describe a modified suture, which mar...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:
更新日期:2005-01-01 00:00:00
abstract:GOAL:Our aim was to investigate fecal microbiota transplantation (FMT) efficacy in patients with severe and/or complicated Clostridium difficile infection (CDI). BACKGROUND:FMT is successful for recurrent CDI, although its benefit in severe or complicated CDI has not specifically been evaluated. STUDY METHODS:A multi...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,多中心研究
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更新日期:2016-05-01 00:00:00
abstract:GOALS:We sought to determine if providers who have higher standards for optimal bowel preparation might be more fastidious in their examination of the colon and, therefore, have higher adenoma detection rates (ADRs). BACKGROUND:ADRs are a reliable and objective marker of colonoscopy performance. Suboptimal bowel prepa...
journal_title:Journal of clinical gastroenterology
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更新日期:2015-10-01 00:00:00
abstract::Cannabinoids have been known as the primary component of cannabis for decades, but the characterization of the endocannabinoid system (ECS) in the 1990s opened the doors for cannabis' use in modern medicine. The 2 main receptors of this system, cannabinoid receptors 1 and 2, are found on cells of various tissues, with...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0000000000001287
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abstract::The main issue regarding the approach to the patient with uninvestigated dyspepsia is whether the symptoms are the result of an important clinical illness, which then determines the appropriate management strategy for the treatment of the symptoms. An initial trial of empiric antisecretory drugs is recommended for tho...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/MCG.0b013e3181c64c69
更新日期:2010-03-01 00:00:00
abstract::The clinicopathologic features of 221 patients with intestinal-type (IT) gastric cancer were compared retrospectively with those of 290 diffuse type (DT). Intestinal type was characterized by an older mean age (65.0 +/- 10.8 years vs. 56.2 +/- 13 years), a higher male-female ratio (2.56 vs. 1.06), predominance of bloo...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-199712000-00019
更新日期:1997-12-01 00:00:00
abstract::We review acid rebound, the seemingly paradoxical increase in acid secretion resulting from administration of an antacid. Primarily a laboratory observation, the demonstration of the phenomenon was a major contributing factor to the swift, and possibly unjustified, fall from grace of calcium carbonate in the therapy o...
journal_title:Journal of clinical gastroenterology
pub_type: 临床试验,杂志文章,随机对照试验,评审
doi:10.1097/00004836-199207000-00010
更新日期:1992-07-01 00:00:00
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journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/MCG.0b013e31817283cb
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abstract:GOALS:To estimate the hepatocellular carcinoma surveillance in the Medicaid cirrhotic population. BACKGROUND:Most studies predate 2005 American Association for the Study of Liver Diseases surveillance recommendations and do not examine the primary target population, cirrhotics. STUDY:From 2006 to 2007, we identified ...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0b013e318286fd97
更新日期:2013-09-01 00:00:00
abstract::A fifty-year-old woman with abdominal pain, diarrhea, and weight loss ultimately required exploratory laparotomy. The entire small intestine was extensively infiltrated by poorly differentiated adenocarcinoma; mesenteric lymph nodes and surrounding omentum were involved, but no extragastrointestinal tumor was found. A...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-198804000-00023
更新日期:1988-04-01 00:00:00
abstract::A 37-year-old man had fever, weight loss, malaise, right upper quadrant pain, lymphadenopathy, and a twofold elevation of serum alkaline phosphatase, transaminases, and gamma glutamyl transpeptidase. Granulomas were found on liver biopsy after 2 1/2 months of illness. Treatment with isoniazid and rifampin for 2 months...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-198906000-00021
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journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-198310000-00013
更新日期:1983-10-01 00:00:00
abstract:BACKGROUND:The prevalence of nonalcoholic fatty liver disease (NAFLD) is rarely reported in Taiwan. GOALS:To determine the prevalence and risk factors of NAFLD in an adult population of Taiwan. STUDY:The cross-sectional community study examined 3245 adults in a rural village of Taiwan. The diagnostic criteria for NAF...
journal_title:Journal of clinical gastroenterology
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doi:10.1097/00004836-200609000-00016
更新日期:2006-09-01 00:00:00
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journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0b013e3182a87e3e
更新日期:2014-03-01 00:00:00
abstract:BACKGROUND:MUC1-glycoprotein is expressed at low levels and in fully glycosylated form on epithelial cells. Inflammation causes MUC1 overexpression and hypoglycosylation. We hypothesized that overexpression of hypoglycosylated MUC1 would be found in postoperative Crohn's disease (CD) recurrence and could be considered ...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0000000000001340
更新日期:2021-02-01 00:00:00
abstract::We postulated that three tests could be used to advantage in the prognosis of patients with alcoholic liver disease. Ninety-eight patients who entered the hospital in hepatic failure, and who survived that illness, were observed for an average of 3.5 years after discharge. At the time of entry, most had jaundice, asci...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-198308000-00003
更新日期:1983-08-01 00:00:00
abstract::In Churug-Strauss Syndrome (CSS), gastrointestinal tract (GIT) is an uncommon site of involvement. In addition to review of recent literature, we herein report a case of CSS with unusual involvement of GIT. The patient was being treated for idiopathic hypereosinophilic syndrome for 2 years; he later developed acute pe...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-199610000-00017
更新日期:1996-10-01 00:00:00
abstract::A patient with cirrhosis developed hemoperitoneum, lactic acidosis, and hyperphosphatemia in the absence of shock. At post-mortem examination occult multicentric hepatocellular carcinoma eroding the liver capsule was present. The case emphasizes the central role of the liver in lactic acidosis, indicates that hemoperi...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-198604000-00025
更新日期:1986-04-01 00:00:00
abstract::Functional anorectal and pelvic pain disorders may cause considerable morbidity and frustration in many women. This article reviews current concepts of these often poorly understood disorders and provides suggestions for evaluating and managing women who may come to the attention of the practicing gastroenterologist. ...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/00004836-200110000-00005
更新日期:2001-10-01 00:00:00
abstract:BACKGROUND:Hepatitis C virus (HCV) infection is prevalent in Latinos. There is some evidence that progression to cirrhosis is more rapid. END POINTS:To calculate time of cirrhosis from time of HCV infection in a large Latino population. Other end points were to assess variables that predict cirrhosis and the effect of...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/01.mcg.0000210105.66994.dc
更新日期:2006-04-01 00:00:00
abstract:GOALS:We evaluated the efficacy of initial and follow-up hepatic venous pressure gradient (HVPG), models of end-stage liver disease (MELD), and MELD-Na for predicting the survival of patients with decompensated liver cirrhosis (LC). BACKGROUND:MELD with/without Na score and HVPG have been important predictors of morta...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0b013e31825f2622
更新日期:2012-11-01 00:00:00