Snee, L. van der (Lizzel) (2021) Effective follow-up methods and future perspectives for patients with curative resected Biliary Tract Cancer. thesis, Medicine.
Full text available on request.Abstract
Introduction: Biliary tract cancer (BTC) accounts for an estimated 3% of all gastrointestinal system malignancies. Partially due to the late onset of symptoms, the mean 5-year survival rate for BTC is between 5 and 18 percent. Radical (R0) resection is currently the only feasible curative treatment. Despite this aggressive surgical approach, the 5-year survival rate remains less than 50%, mostly due to the high recurrence rate. To increase survival, early detection of recurrence and subsequent quick start of palliative chemotherapy could help. The most effective follow-up method to find recurrence remains unknown. The aim is to investigate the effectiveness of cancer antigen 19-9 (CA 19-9) in the detection of recurrence. Methods: This multicentre, retrospective cohort study included patients with non-standardized follow-up after curative resection for BTC from January 2016 to February 2020 in the Amsterdam UMC. The primary outcome was to identify a significance in the increase of CA 19-9 and recurrence. Results: A total of 62 patients were included of whom 33 (53%) patients had radiological recurrence. From these patients 25 (76%) patients presented with complaints and in 8 (24%) patients recurrence occurred during regular follow-up. The level of CA 19-9 in patients with recurrence versus no recurrence was 67 U/ml (IQR 14-2603) and 18 U/ml (IQR 11-54), respectively (P = 0.040). Conclusion: This study showed patients who received non-standardized surveillance had more increased CA 19-9 levels, although physical complaints more often pointed out recurrence. Future research should compare standardized and non-standardized surveillance to point out if standardized surveillance of CA 19-9 is beneficial in detecting recurrence.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Nooijen, drs. L.E. and Erdmann, dr. J.I. and Klaase, prof. dr. J.M. |
| Faculty: | Medical Sciences |
| Date Deposited: | 07 Jan 2022 08:37 |
| Last Modified: | 07 Jan 2022 08:37 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2979 |
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