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Article: The Effect of Rice vs. Wheat Ingestion on Postprandial Gastroesophageal Reflux (GER) Symptoms in Patients with Overlapping GERD-Irritable Bowel Syndrome (IBS)

Patcharatrakul, Tanisa / Linlawan, Sittikorn / Plaidum, Suppawatsa / Gonlachanvit, Sutep

Foods. 2021 Dec. 23, v. 11, no. 1

2021

Abstract: A randomized crossover study in twenty-one patients (18F, age 50 ± 13 years) with overlapping GERD-IBS was conducted to evaluate the effects of rice noodles (low FODMAPs) vs. wheat noodles (high FODMAPs) on typical GER symptoms, and the correlation ... ...

Abstract	A randomized crossover study in twenty-one patients (18F, age 50 ± 13 years) with overlapping GERD-IBS was conducted to evaluate the effects of rice noodles (low FODMAPs) vs. wheat noodles (high FODMAPs) on typical GER symptoms, and the correlation between GERD symptoms and intestinal gas production. Results: Heartburn and regurgitation scores were highest in most patients (19/21) during the first 15 min after meals. At 15 min after lunch, wheat was significantly associated with more regurgitation and heartburn than rice. Also, at 15 min after breakfast, wheat aggravated more regurgitation than rice. Wheat ingestion was significantly associated with higher H₂ and CH₄ levels after lunch compared to rice, whereas gas levels before lunch were similar (p > 0.05). The area under the curve of H₂ and CH₄ concentration 15 min after a lunch of wheat moderately correlated with the regurgitation severity at 15-min (r = 0.56, p < 0.05). Conclusion: Wheat induced more GERD symptoms than rice in patients with overlapping GERD-IBS. This effect, immediately developed after lunch, was associated with more intestinal gas production. Thus, a low FODMAPs diet may relieve postprandial GERD symptoms in GERD patients with overlapping IBS. Wheat inducing more regurgitation than rice after breakfast suggests other mechanism(s) besides gut fermentation.
Keywords	FODMAP diet ; breakfast ; cross-over studies ; fermentation ; gastroesophageal reflux ; ingestion ; intestines ; lunch ; rice ; wheat
Language	English
Dates of publication	2021-1223
Publishing place	Multidisciplinary Digital Publishing Institute
Document type	Article
ZDB-ID	2704223-6
ISSN	2304-8158
ISSN	2304-8158
DOI	10.3390/foods11010026
Database	NAL-Catalogue (AGRICOLA)

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Article: The Effect of Rice vs. Wheat Ingestion on Postprandial Gastroesophageal Reflux (GER) Symptoms in Patients with Overlapping GERD-Irritable Bowel Syndrome (IBS).

Patcharatrakul, Tanisa / Linlawan, Sittikorn / Plaidum, Suppawatsa / Gonlachanvit, Sutep

Foods (Basel, Switzerland)

2021 Volume 11, Issue 1

Abstract	A randomized crossover study in twenty-one patients (18F, age 50 ± 13 years) with overlapping GERD-IBS was conducted to evaluate the effects of rice noodles (low FODMAPs) vs. wheat noodles (high FODMAPs) on typical GER symptoms, and the correlation between GERD symptoms and intestinal gas production. Results: Heartburn and regurgitation scores were highest in most patients (19/21) during the first 15 min after meals. At 15 min after lunch, wheat was significantly associated with more regurgitation and heartburn than rice. Also, at 15 min after breakfast, wheat aggravated more regurgitation than rice. Wheat ingestion was significantly associated with higher H
Language	English
Publishing date	2021-12-23
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2704223-6
ISSN	2304-8158
ISSN	2304-8158
DOI	10.3390/foods11010026
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Article: Effect of Rice, Wheat, and Mung Bean Ingestion on Intestinal Gas Production and Postprandial Gastrointestinal Symptoms in Non-Constipation Irritable Bowel Syndrome Patients

Linlawan, Sittikorn / Patcharatrakul, Tanisa / Somlaw, Nicha / Gonlachanvit, Sutep

Nutrients. 2019 Sept. 03, v. 11, no. 9

2019

Abstract: The aim of this study is to evaluate the effect of rice, mung bean, and wheat noodle ingestion on intestinal gas production and postprandial gastrointestinal (GI) symptoms in non-constipation irritable bowel syndrome (IBS) patients. Methods: Twenty ... ...

Abstract	The aim of this study is to evaluate the effect of rice, mung bean, and wheat noodle ingestion on intestinal gas production and postprandial gastrointestinal (GI) symptoms in non-constipation irritable bowel syndrome (IBS) patients. Methods: Twenty patients (13 F, 46 ± 11 y) underwent 8 h breath test studies and GI symptom evaluations after standard rice, wheat, or mung bean noodle meals at 8:00 a.m. in a randomized crossover study with a 1-week washout period. The same meal was ingested at 12:00 p.m. Results: The H<inf>2</inf> and CH<inf>4</inf> concentration in the breath samples were similar at baseline (rice:wheat:mung bean, H<inf>2</inf> = 3.6 ± 0.5:4.1 ± 0.5:4.0 ± 0.7 ppm, CH<inf>4</inf> = 1.3 ± 0.3:2.1 ± 0.4:1.9 ± 0.4 ppm, p > 0.05). Beginning at the fifth hour after breakfast, H<inf>2</inf> and CH<inf>4</inf> concentrations significantly increased after wheat compared to rice and mung bean (8 h AUC H<inf>2</inf> = 4120 ± 2622:2267 ± 1780:2356 ± 1722, AUC CH<inf>4</inf> = 1617 ± 1127:946 ± 664:943 ± 584 ppm-min, respectively) (p < 0.05). Bloating and satiety scores significantly increased after wheat compared to rice (p < 0.05), and increased but did not reach statistical significance compared to mung bean (p > 0.05). A higher bloating score after wheat compared to rice and mung bean was observed clearly after lunch but not after breakfast. Conclusion: Wheat ingestion produced more intestinal gas and more bloating and satiety scores compared to rice and mung bean, especially after lunch. This provides insight into the role of intestinal gas in the development of bloating symptoms in IBS.
Keywords	breakfast ; breath tests ; cross-over studies ; food intake ; hydrogen ; intestines ; irritable bowel syndrome ; lunch ; methane ; mung beans ; noodles ; patients ; rice ; satiety ; wheat
Language	English
Dates of publication	2019-0903
Publishing place	Multidisciplinary Digital Publishing Institute
Document type	Article
ZDB-ID	2518386-2
ISSN	2072-6643
ISSN	2072-6643
DOI	10.3390/nu11092061
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Article ; Online: Effect of Rice, Wheat, and Mung Bean Ingestion on Intestinal Gas Production and Postprandial Gastrointestinal Symptoms in Non-Constipation Irritable Bowel Syndrome Patients.

Linlawan, Sittikorn / Patcharatrakul, Tanisa / Somlaw, Nicha / Gonlachanvit, Sutep

Nutrients

2019 Volume 11, Issue 9

Abstract	The aim of this study is to evaluate the effect of rice, mung bean, and wheat noodle ingestion on intestinal gas production and postprandial gastrointestinal (GI) symptoms in non-constipation irritable bowel syndrome (IBS) patients. Methods: Twenty patients (13 F, 46 ± 11 y) underwent 8 h breath test studies and GI symptom evaluations after standard rice, wheat, or mung bean noodle meals at 8:00 a.m. in a randomized crossover study with a 1-week washout period. The same meal was ingested at 12:00 p.m. Results: The H Conclusion: Wheat ingestion produced more intestinal gas and more bloating and satiety scores compared to rice and mung bean, especially after lunch. This provides insight into the role of intestinal gas in the development of bloating symptoms in IBS.
MeSH term(s)	Adult ; Breath Tests ; Cross-Over Studies ; Diet ; Female ; Humans ; Irritable Bowel Syndrome/metabolism ; Irritable Bowel Syndrome/pathology ; Male ; Methane/chemistry ; Methane/metabolism ; Middle Aged ; Oryza ; Postprandial Period ; Triticum ; Vigna
Chemical Substances	Methane (OP0UW79H66)
Language	English
Publishing date	2019-09-03
Publishing country	Switzerland
Document type	Journal Article ; Randomized Controlled Trial
ZDB-ID	2518386-2
ISSN	2072-6643 ; 2072-6643
ISSN (online)	2072-6643
ISSN	2072-6643
DOI	10.3390/nu11092061
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Article ; Online: Hemostatic Powder vs Standard Endoscopic Treatment for Gastrointestinal Tumor Bleeding: A Multicenter Randomized Trial.

Pittayanon, Rapat / Khongka, Wichitra / Linlawan, Sittikorn / Thungsuk, Rattikorn / Aumkaew, Surasak / Teeratorn, Nicha / Maytapa, Jeerawat / Kimtrakool, Sayamon / Pakvisal, Piyapoom / Kongtub, Natanong / Rerknimitr, Rungsun / Barkun, Alan

Gastroenterology

2023 Volume 165, Issue 3, Page(s) 762–772.e2

Abstract: Background & aims: Current guidelines vary as to their recommendations addressing the role of hemostatic powders when managing patients with malignant gastrointestinal (GI) bleeding because these are based on very-low- to low-quality evidence, in large ... ...

Abstract	Background & aims: Current guidelines vary as to their recommendations addressing the role of hemostatic powders when managing patients with malignant gastrointestinal (GI) bleeding because these are based on very-low- to low-quality evidence, in large part due to a paucity of randomized trial data. Methods: This was a patient- and outcome assessor-blinded, multicenter, randomized controlled trial. Patients presenting with active bleeding from an upper or lower GI lesion suspected to be malignant at index endoscopy between June 2019 and January 2022 were randomly allocated to receive either TC-325 alone or standard endoscopic treatment (SET). The primary outcome was 30-day rebleeding, and secondary objectives included immediate hemostasis and other clinically relevant endpoints. Results: Overall, 106 patients made up the study population (55 TC-325 and 51 SET, after 1 exclusion in the TC-325 group and 5 in the SET group). Baseline characteristics and endoscopic findings did not differ between the groups. Thirty-day rebleeding was significantly lower in the TC-325 (2.1% TC-325 vs 21.3% SET; odds ratio, 0.09; 95% confidence interval [CI], 0.01-0.80; P = .003). Immediate hemostasis rates were 100% in the TC-325 group vs 68.6% in the SET group (odds ratio, 1.45; 95% CI, 0.93-2.29; P < .001). Other secondary outcomes did not differ between the 2 groups. Independent predictors of 6-month survival included the Charlson comorbidity index (hazard ratio, 1.17; 95% CI, 1.05-1.32; P = .007) and receiving an additional nonendoscopic hemostatic or oncologic treatment during 30 days after the index endoscopy (hazard ratio, 0.16; 95% CI, 0.06-0.43; P < .001) after adjustment for functional status, Glasgow-Blatchford score, and an upper GI source of bleeding. Conclusion: The TC-325 hemostatic powder results in greater immediate hemostasis rates followed by lower 30-day rebleeding rates when compared to contemporary SET. (ClinicalTrials.gov, Number: NCT03855904).
MeSH term(s)	Humans ; Powders ; Hemostasis, Endoscopic/adverse effects ; Hemostasis, Endoscopic/methods ; Neoplasm Recurrence, Local/therapy ; Gastrointestinal Hemorrhage/etiology ; Gastrointestinal Hemorrhage/surgery ; Gastrointestinal Neoplasms/complications ; Gastrointestinal Neoplasms/surgery ; Endoscopy, Gastrointestinal/adverse effects ; Hemostatics/therapeutic use ; Recurrence
Chemical Substances	hemospray ; Powders ; Hemostatics
Language	English
Publishing date	2023-06-03
Publishing country	United States
Document type	Randomized Controlled Trial ; Multicenter Study ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	80112-4
ISSN	1528-0012 ; 0016-5085
ISSN (online)	1528-0012
ISSN	0016-5085
DOI	10.1053/j.gastro.2023.05.042
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Article ; Online: Improvement of adenoma detection rate by two computer-aided colonic polyp detection systems in high adenoma detectors: a randomized multicenter trial.

Tiankanon, Kasenee / Aniwan, Satimai / Kerr, Stephen J / Mekritthikrai, Krittaya / Kongtab, Natanong / Wisedopas, Naruemon / Piyachaturawat, Panida / Kulpatcharapong, Santi / Linlawan, Sittikorn / Phromnil, Poonrada / Muangpaisarn, Puth / Orprayoon, Theerapat / Chanyaswad, Jaruwan / Sunthornwechapong, Panukorn / Vateekul, Peerapon / Kullavanijaya, Pinit / Rerknimitr, Rungsun

Endoscopy

2023 Volume 56, Issue 4, Page(s) 273–282

Abstract: Background: This study aimed to evaluate the benefits of a self-developed computer-aided polyp detection system (SD-CADe) and a commercial system (CM-CADe) for high adenoma detectors compared with white-light endoscopy (WLE) as a control.: Methods: ... ...

Abstract	Background: This study aimed to evaluate the benefits of a self-developed computer-aided polyp detection system (SD-CADe) and a commercial system (CM-CADe) for high adenoma detectors compared with white-light endoscopy (WLE) as a control. Methods: Average-risk 50-75-year-old individuals who underwent screening colonoscopy at five referral centers were randomized to SD-CADe, CM-CADe, or WLE groups (1:1:1 ratio). Trainees and staff with an adenoma detection rate (ADR) of ≥35% were recruited. The primary outcome was ADR. Secondary outcomes were the proximal adenoma detection rate (pADR), advanced adenoma detection rate (AADR), and the number of adenomas, proximal adenomas, and advanced adenomas per colonoscopy (APC, pAPC, and AAPC, respectively). Results: The study enrolled 1200 participants. The ADR in the control, CM-CADe, and SD-CADe groups was 38.3%, 50.0%, and 54.8%, respectively. The pADR was 23.0%, 32.3%, and 38.8%, respectively. AADR was 6.0%, 10.3%, and 9.5%, respectively. After adjustment, the ADR and pADR in both intervention groups were significantly higher than in controls (all P<0.05). The APC in the control, CM-CADe, and SD-CADe groups was 0.66, 1.04, and 1.16, respectively. The pAPC was 0.33, 0.53, and 0.64, respectively, and the AAPC was 0.07, 0.12, and 0.10, respectively. Both CADe systems showed significantly higher APC and pAPC than WLE. AADR and AAPC were improved in both CADe groups versus control, although the differences were not statistically significant. Conclusion: Even in high adenoma detectors, CADe significantly improved ADR and APC. The AADR tended to be higher with both systems, and this may enhance colorectal cancer prevention.
MeSH term(s)	Humans ; Middle Aged ; Aged ; Colonic Polyps/diagnostic imaging ; Colonoscopy ; Adenoma/diagnostic imaging ; Mass Screening ; Computers ; Colorectal Neoplasms/diagnosis
Language	English
Publishing date	2023-11-14
Publishing country	Germany
Document type	Randomized Controlled Trial ; Multicenter Study ; Clinical Trial
ZDB-ID	80120-3
ISSN	1438-8812 ; 0013-726X
ISSN (online)	1438-8812
ISSN	0013-726X
DOI	10.1055/a-2210-7999
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Article ; Online: Post liver transplantation lymphoproliferative disorder mimics recurrence of hepatocellular carcinoma.

Poovorawan, Kittiyod / Linlawan, Sittikorn / Wisedopas, Naruemon / Komolmit, Piyawat

BMJ case reports

2013 Volume 2013

Abstract: We report a case of Epstein-Barr virus (EBV)-related postliver transplantation lymphoproliferative disorder (PTLD) in a patient with post liver transplant which initially presented in a CT scan image mimicking recurrence of hepatocellular carcinoma. ... ...

Abstract	We report a case of Epstein-Barr virus (EBV)-related postliver transplantation lymphoproliferative disorder (PTLD) in a patient with post liver transplant which initially presented in a CT scan image mimicking recurrence of hepatocellular carcinoma. Histopathology showed atypical plasma cell-like infiltration, and immunohistochemistry confirmed diagnosis of EBV-associated diffuse large B-cell lymphoma. Typical imaging from dynamic phases contrast CT scan might not accurately diagnose recurrent HCC in postorthotropic liver transplantation. Liver biopsy should be performed for accurate diagnosis and proper treatment.
MeSH term(s)	Biopsy ; Carcinoma, Hepatocellular/diagnosis ; Carcinoma, Hepatocellular/surgery ; Epstein-Barr Virus Infections/diagnosis ; Epstein-Barr Virus Infections/pathology ; Epstein-Barr Virus Infections/virology ; Humans ; Immunosuppression ; Liver/pathology ; Liver/virology ; Liver Neoplasms/diagnosis ; Liver Neoplasms/pathology ; Liver Neoplasms/surgery ; Liver Neoplasms/virology ; Liver Transplantation ; Lymphoma, Large B-Cell, Diffuse/diagnosis ; Lymphoma, Large B-Cell, Diffuse/pathology ; Lymphoma, Large B-Cell, Diffuse/virology ; Male ; Middle Aged ; Postoperative Complications/diagnosis ; Postoperative Complications/virology ; Recurrence
Language	English
Publishing date	2013-12-18
Publishing country	England
Document type	Case Reports ; Journal Article
ISSN	1757-790X
ISSN (online)	1757-790X
DOI	10.1136/bcr-2013-200837
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Article: Improvement of adenoma detection rate by two computer-aided colonic polyp detection systems in high adenoma detectors: a randomized multicenter trial

Endoscopy

2023 Volume 56, Issue 04, Page(s) 273–282

Abstract	Background: This study aimed to evaluate the benefits of a self-developed computer-aided polyp detection system (SD-CADe) and a commercial system (CM-CADe) for high adenoma detectors compared with white-light endoscopy (WLE) as a control. Methods: Average-risk 50–75-year-old individuals who underwent screening colonoscopy at five referral centers were randomized to SD-CADe, CM-CADe, or WLE groups (1:1:1 ratio). Trainees and staff with an adenoma detection rate (ADR) of ≥35% were recruited. The primary outcome was ADR. Secondary outcomes were the proximal adenoma detection rate (pADR), advanced adenoma detection rate (AADR), and the number of adenomas, proximal adenomas, and advanced adenomas per colonoscopy (APC, pAPC, and AAPC, respectively). Results: The study enrolled 1200 participants. The ADR in the control, CM-CADe, and SD-CADe groups was 38.3%, 50.0%, and 54.8%, respectively. The pADR was 23.0%, 32.3%, and 38.8%, respectively. AADR was 6.0%, 10.3%, and 9.5%, respectively. After adjustment, the ADR and pADR in both intervention groups were significantly higher than in controls (all P<0.05). The APC in the control, CM-CADe, and SD-CADe groups was 0.66, 1.04, and 1.16, respectively. The pAPC was 0.33, 0.53, and 0.64, respectively, and the AAPC was 0.07, 0.12, and 0.10, respectively. Both CADe systems showed significantly higher APC and pAPC than WLE. AADR and AAPC were improved in both CADe groups versus control, although the differences were not statistically significant. Conclusion: Even in high adenoma detectors, CADe significantly improved ADR and APC. The AADR tended to be higher with both systems, and this may enhance colorectal cancer prevention.
Language	English
Publishing date	2023-11-14
Publisher	Georg Thieme Verlag KG
Publishing place	Stuttgart ; New York
Document type	Article
ZDB-ID	80120-3
ISSN	1438-8812 ; 0013-726X
ISSN (online)	1438-8812
ISSN	0013-726X
DOI	10.1055/a-2210-7999
Database	Thieme publisher's database

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Article ; Online: Aloe vera attenuated liver injury in mice with acetaminophen-induced hepatitis

Werawatganon, Duangporn / Linlawan, Sittikorn / Thanapirom, Kessarin / Somanawat, Kanjana / Klaikeaw, Naruemon / Rerknimitr, Rungsun / Siriviriyakul, Prasong

BMC Complement Altern Med. 2014 Dec., v. 14, no. 1 p.229-229

2014

Abstract: BACKGROUND: An overdose of the acetaminophen causes liver injury. This study aims to examine the anti-oxidative, anti-inflammatory effects of Aloe vera in mice with acetaminophen induced hepatitis. METHODS: Male mice were randomly divided into three ... ...

Abstract	BACKGROUND: An overdose of the acetaminophen causes liver injury. This study aims to examine the anti-oxidative, anti-inflammatory effects of Aloe vera in mice with acetaminophen induced hepatitis. METHODS: Male mice were randomly divided into three groups (n = 8 each). Control group were given orally distilled water (DW). APAP group were given orally N-acetyl-P-aminophenol (APAP) 400 mg/kg suspended in DW. Aloe vera-treated group were given orally APAP and Aloe vera (150 mg/kg) suspended in DW. Twenty-four hours later, the liver was removed to determine hepatic malondialdehyde (MDA), hepatic glutathione (GSH), the number of interleukin (IL)-12 and IL-18 positive stained cells (%) by immunohistochemistry method, and histopathological examination. Then, the serum was collected to determine transaminase (ALT). RESULTS: In APAP group, ALT, hepatic MDA and the number of IL-12 and IL-18 positive stained cells were significantly increased when compared to control group (1210.50 ± 533.86 vs 85.28 ± 28.27 U/L, 3.60 ± 1.50 vs 1.38 ± 0.15 nmol/mg protein, 12.18 ± 1.10 vs 1.84 ± 1.29%, and 13.26 ± 0.90 vs 2.54 ± 1.29%, P = 0.000, respectively), whereas hepatic GSH was significantly decreased when compared to control group (5.98 ± 0.30 vs 11.65 ± 0.43 nmol/mg protein, P = 0.000). The mean level of ALT, hepatic MDA, the number of IL-12 and IL-18 positive stained cells, and hepatic GSH in Aloe vera-treated group were improved as compared with APAP group (606.38 ± 495.45 vs 1210.50 ± 533.86 U/L, P = 0.024; 1.49 ± 0.64 vs 3.60 ± 1.50 nmol/mg protein, P = 0.001; 5.56 ± 1.25 vs 12.18 ± 1.10%, P = 0.000; 6.23 ± 0.94 vs 13.26 ± 0.90%, P = 0.000; and 10.02 ± 0.20 vs 5.98 ± 0.30 nmol/mg protein, P = 0.000, respectively). Moreover, in the APAP group, the liver showed extensive hemorrhagic hepatic necrosis at all zones while in Aloe vera-treated group, the liver architecture was improved histopathology. CONCLUSIONS: APAP overdose can cause liver injury. Our result indicate that Aloe vera attenuate APAP-induced hepatitis through the improvement of liver histopathology by decreased oxidative stress, reduced liver injury, and restored hepatic GSH.
Keywords	Aloe vera ; acetaminophen ; blood serum ; complement ; glutathione ; hepatitis ; histopathology ; immunohistochemistry ; interleukin-12 ; interleukin-18 ; liver ; males ; malondialdehyde ; necrosis ; overdose ; oxidative stress
Language	English
Dates of publication	2014-12
Size	p. 229.
Publishing place	BioMed Central
Document type	Article ; Online
Note	Resource is Open Access
ZDB-ID	2050429-9
ISSN	1472-6882
ISSN	1472-6882
DOI	10.1186/1472-6882-14-229
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Article ; Online: Outcome and validation of a new clinically based staging system for predicting survival of perihilar cholangiocarcinoma patients.

Laoveeravat, Passisd / Jaruvongvanich, Veeravich / Wongjarupong, Nicha / Linlawan, Sittikorn / Tanpowpong, Natthaporn / Phathong, Chonlada / Phatharacharukul, Parkpoom / Treeprasertsuk, Sombat / Rerknimitr, Rungsun / Chaiteerakij, Roongruedee

JGH open : an open access journal of gastroenterology and hepatology

2017 Volume 1, Issue 2, Page(s) 56–61

Abstract: Background and aim: Currently available staging systems for cholangiocarcinoma (CCA) are not applicable to patients with unresectable stage. A new clinical staging system for perihilar CCA (pCCA) subtype has been recently developed in a US cohort, with ... ...

Abstract	Background and aim: Currently available staging systems for cholangiocarcinoma (CCA) are not applicable to patients with unresectable stage. A new clinical staging system for perihilar CCA (pCCA) subtype has been recently developed in a US cohort, with a good performance in predicting survival of all pCCA patients. We aimed to determine outcomes of pCCA patients and evaluate predictive performance of this staging system in an Asian population. Methods: All 141 patients diagnosed with pCCA between 2003 and 2012 were identified. Clinical information was retrospectively abstracted. Patients were classified into four stages based on the new staging system. Survival predictors were analyzed using the Cox proportional hazard analysis. Results: Of the 141 pCCA patients, 38 (27%), 101 (72%), and 2 (1%) received resection, palliative biliary drainage ± chemotherapy, and best supportive care, respectively. Survival predictors included resectable disease, tumor size, distant metastasis, and cancer antigen 19-9 ≥ 1000 U/mL. When classified by clinical stages, 13, 4, 99, and 25 patients were in stages I, II, III, and IV, with median survivals of 18.4, 7.3, 6.3, and 2.6 months; and hazard ratio (95% confidence interval) of 1.0 (reference), 1.7 (0.5-5.5), 3.2 (1.5-6.7), and 10.8 (4.6-25.0), respectively. Conclusion: The clinical staging system has a limited performance in differentiating stage II pCCA patients from stage III patients in the Thai cohort. This can be due to differences in patient characteristics and treatment modalities between the Asian and White pCCA populations. However, the median survivals of patients with other stages are significantly different.
Language	English
Publishing date	2017-10-06
Publishing country	Australia
Document type	Journal Article
ISSN	2397-9070
ISSN (online)	2397-9070
DOI	10.1002/jgh3.12009
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