Systematic review of cholangiocarcinoma in Africa: epidemiology, management, and clinical outcomes.
Africa
Cholangiocarcinoma
Epidemiology
Risk factors
Systematic review
Journal
BMC gastroenterology
ISSN: 1471-230X
Titre abrégé: BMC Gastroenterol
Pays: England
ID NLM: 100968547
Informations de publication
Date de publication:
11 Mar 2023
11 Mar 2023
Historique:
received:
18
08
2022
accepted:
20
02
2023
entrez:
11
3
2023
pubmed:
13
3
2023
medline:
15
3
2023
Statut:
epublish
Résumé
The prevalence, management, and clinical outcomes of cholangiocarcinoma in Africa are unknown. The aim is to conduct a comprehensive systematic review on the epidemiology, management, and outcomes of cholangiocarcinoma in Africa. We searched PubMed, EMBASE, Web of Science and CINHAL from inception up to November 2019 for studies on cholangiocarcinoma in Africa. The results reported follow PRISMA guidelines. Quality of studies and risk of bias were adapted from a standard quality assessment tool. Descriptive data were expressed as numbers with proportions and Chi-squared test was used to compare proportions. P values < 0.05 were considered significant. A total of 201 citations were identified from the four databases. After excluding duplicates, 133 full texts were reviewed for eligibility, and 11 studies were included. The 11 studies are reported from 4 countries only: 8 are from North Africa (Egypt 6 and Tunisia 2), and 3 in Sub-Saharan Africa (2 in South Africa, 1 in Nigeria). Ten studies reported management and outcomes, while one study reported epidemiology and risk factors. Median age for cholangiocarcinoma ranged between 52 and 61 years. Despite the proportion with cholangiocarcinoma being higher among males than females in Egypt, this gender disparity could not be demonstrated in other African countries. Chemotherapy is mainly used for palliative care. Surgical interventions are curative and prevent cancer progression. Statistical analyses were performed with Stata 15.1. The known global major risk factors such as primary sclerosing cholangitis, Clonorchis sinensis and Opisthorchis viverrini infestation are rare. Chemotherapy treatment was mainly used for palliative treatment and was reported in three studies. Surgical intervention was described in at least 6 studies as a curative modality of treatment. Diagnostic capabilities such as radiographic imaging and endoscopic are lacking across the continent which most likely plays a role in accurate diagnosis.
Sections du résumé
BACKGROUND
BACKGROUND
The prevalence, management, and clinical outcomes of cholangiocarcinoma in Africa are unknown. The aim is to conduct a comprehensive systematic review on the epidemiology, management, and outcomes of cholangiocarcinoma in Africa.
METHODS
METHODS
We searched PubMed, EMBASE, Web of Science and CINHAL from inception up to November 2019 for studies on cholangiocarcinoma in Africa. The results reported follow PRISMA guidelines. Quality of studies and risk of bias were adapted from a standard quality assessment tool. Descriptive data were expressed as numbers with proportions and Chi-squared test was used to compare proportions. P values < 0.05 were considered significant.
RESULTS
RESULTS
A total of 201 citations were identified from the four databases. After excluding duplicates, 133 full texts were reviewed for eligibility, and 11 studies were included. The 11 studies are reported from 4 countries only: 8 are from North Africa (Egypt 6 and Tunisia 2), and 3 in Sub-Saharan Africa (2 in South Africa, 1 in Nigeria). Ten studies reported management and outcomes, while one study reported epidemiology and risk factors. Median age for cholangiocarcinoma ranged between 52 and 61 years. Despite the proportion with cholangiocarcinoma being higher among males than females in Egypt, this gender disparity could not be demonstrated in other African countries. Chemotherapy is mainly used for palliative care. Surgical interventions are curative and prevent cancer progression. Statistical analyses were performed with Stata 15.1.
CONCLUSION
CONCLUSIONS
The known global major risk factors such as primary sclerosing cholangitis, Clonorchis sinensis and Opisthorchis viverrini infestation are rare. Chemotherapy treatment was mainly used for palliative treatment and was reported in three studies. Surgical intervention was described in at least 6 studies as a curative modality of treatment. Diagnostic capabilities such as radiographic imaging and endoscopic are lacking across the continent which most likely plays a role in accurate diagnosis.
Identifiants
pubmed: 36906562
doi: 10.1186/s12876-023-02687-6
pii: 10.1186/s12876-023-02687-6
pmc: PMC10007746
doi:
Types de publication
Journal Article
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
66Informations de copyright
© 2023. The Author(s).
Références
Int J Parasitol. 2005 Oct;35(11-12):1255-78
pubmed: 16150452
Int J Surg. 2014;12(8):762-7
pubmed: 24909136
World J Gastroenterol. 2015 Dec 28;21(48):13418-31
pubmed: 26730152
Tumour Biol. 2014 Jul;35(7):6831-8
pubmed: 24729126
BMB Rep. 2016 Nov;49(11):590-597
pubmed: 27418285
Hepatogastroenterology. 2007 Sep;54(78):1626-31
pubmed: 18019680
Int J Colorectal Dis. 1988 Nov;3(4):222-5
pubmed: 3198993
Clin Liver Dis (Hoboken). 2016 Aug;8(2):43-47
pubmed: 27822365
Int J Cancer. 1991 Sep 9;49(2):182-5
pubmed: 1831801
Hepatology. 2021 Jul;74(1):491-502
pubmed: 33222247
Gut. 1997 Nov;41(5):688-9
pubmed: 9414979
Emerg Themes Epidemiol. 2008 Nov 17;5:23
pubmed: 19014686
S Afr J Surg. 2012 Jul 11;50(3):54, 56, 58 passim
pubmed: 22856436
Ann Surg. 2007 May;245(5):755-62
pubmed: 17457168
J Am Coll Surg. 1995 Dec;181(6):567-81
pubmed: 7582236
BMC Cancer. 2002 May 03;2:10
pubmed: 11991810
J Vet Med B Infect Dis Vet Public Health. 2005 Nov;52(9):414-6
pubmed: 16283922
Radiat Res. 2003 Dec;160(6):691-706
pubmed: 14640794
Hepatogastroenterology. 2006 Jan-Feb;53(67):5-10
pubmed: 16506367
JAMA Intern Med. 2016 Oct 01;176(10):1474-1481
pubmed: 27478902
Cell Death Dis. 2020 May 4;11(5):313
pubmed: 32366840
Liver Int. 2019 May;39 Suppl 1:19-31
pubmed: 30851228
Int J Cancer. 2019 Feb 15;144(4):707-717
pubmed: 30155920
Carcinogenesis. 2016 Aug;37(8):817-826
pubmed: 27267998
Ann Surg. 2008 Jul;248(1):84-96
pubmed: 18580211
Liver Transpl. 2018 Feb;24(2):294-303
pubmed: 29024405
Cancer Sci. 2010 Mar;101(3):579-85
pubmed: 20085587
World J Gastrointest Oncol. 2021 Dec 15;13(12):2050-2063
pubmed: 35070041
Hepatogastroenterology. 2012 Mar-Apr;59(114):321-4
pubmed: 22328268
Semin Cell Dev Biol. 2002 Dec;13(6):389-96
pubmed: 12468238
Hepatogastroenterology. 2003 Mar-Apr;50(50):337-41
pubmed: 12749216
Curr Gastroenterol Rep. 2011 Apr;13(2):182-7
pubmed: 21271364
Surg Oncol. 2007 Dec;16(4):277-91
pubmed: 17935975
S Afr J Surg. 2007 Feb;45(1):12-6
pubmed: 17969772
Nat Rev Gastroenterol Hepatol. 2011 Aug 02;8(9):512-22
pubmed: 21808282
J Egypt Soc Parasitol. 2011 Apr;41(1):221-5
pubmed: 21634255
Liver Int. 2019 May;39 Suppl 1:98-107
pubmed: 30831002
Hepatogastroenterology. 2010 May-Jun;57(99-100):414-9
pubmed: 20698200
World J Gastrointest Surg. 2016 Jun 27;8(6):436-43
pubmed: 27358676