Wikipedia:Peer review/Cholangiocarcinoma/archive1

Cholangiocarcinoma

I'm looking for feedback on the organization, prose clarity, usefulness, and completeness of this article. Any public-domain images that could be added would be highly appreciated. MastCell 21:51, 14 March 2007 (UTC)

• I have an impressive CT and ERCP image from today. Will add soon or e-mail to you -- 74.12.86.222 01:39, 15 March 2007 (UTC)

That would be great - thanks. MastCell 02:22, 15 March 2007 (UTC)

To do list

• Very interesting. Some comments:
  • Lead is very short and could be expanded.

Done. MastCell ^Talk 18:46, 20 March 2007 (UTC)

• • You could explain more what the significance is of the "obstructive picture" - I think this is related to a question I had further down. Since obstructive jaundice redirects to jaundice, I'd like to see more about what makes a doctor suspect an obstructive cause.

Added a (brief) description of how liver function tests may help differentiate an obstructive cause of jaundice (such as cholangiocarcinoma) from an inflammatory/infectious cause (e.g. hepatitis). Perhaps when I get around to it, more detailed info could be added to liver function test. MastCell ^Talk 17:03, 20 March 2007 (UTC)

• • THe mass of footnotes in the epidemiology section could be condensed. The ones that aren't cited elsewhere can just be fused into one note with multiple references.

Done. Excellent suggestion. MastCell ^Talk 17:09, 20 March 2007 (UTC)

• • The risk factors section is a list that happens not to have bullet points. This needs prosification.

Gave this a shot. MastCell ^Talk 23:41, 18 March 2007 (UTC)

• • There could be more explanation of why PSC is a risk factor, assuming that some mechanism is known. Since it's such a major risk factor, mentioning its prevalence and cause would also be useful.

Tried to address this - the mechanism is really not well-understood as best I know or can find. I debated how much info on PSC to include, since it's so tightly linked epidemiologically, but in the end I didn't want to duplicate a lot of info from the primary sclerosing cholangitis article. The disease is inflammatory and believed to possibly be autoimmune (given its association with the autoimmune disease ulcerative colitis, for example), but even that much is somewhat controversial and murky. MastCell ^Talk 17:33, 20 March 2007 (UTC)

• • Blood tests section - write out (and ideally explain) CEA, and clarify the question of whether it's the serum levels that aren't sensitive enough (not elevated that much above normal) or the tests that aren't sensitive enough to detect the elevation reliably. These refs can be condensed too.

Condensed refs and tried to clarify; there are some conflicting data, but in general blood tests (CEA and CA19-9) may be a useful clue in supporting a suspected diagnosis of cholangiocarcinoma, but they lack the sensitvity/specificity for general screening. MastCell ^Talk 17:52, 20 March 2007 (UTC)

• • Write out 'laparotomy' and use the current link text as an appositive explanation. I don't know if there's a 'standard', but I hate seeing jargony words obscured like that.

Done. MastCell ^Talk 18:00, 20 March 2007 (UTC)

• • What's the direct cause of death in patients that die of this?

In general, the cause of death in people with advanced cholangiocarcinoma is either liver failure from ongoing bile-duct obstruction, or infection of the bile ducts (cholangitis) which occurs because they're blocked and unable to drain properly. Cancer-associated wasting (cachexia) is also a contributor in a lot of cases, as the resulting malnutrition makes people more susceptible to infection. However, I have not been able to find a source to which I could attribute those fairly commonplace observations. MastCell ^Talk 18:14, 20 March 2007 (UTC)

• • It sounds like the Klatkin tumor could fit into the text, one-item see also look wimpy.

Done. MastCell ^Talk 17:16, 20 March 2007 (UTC)

• • Not sure you really need to link March 2007; that page has nothing relevant on it.

Done. MastCell ^Talk 17:19, 20 March 2007 (UTC)

Opabinia regalis 01:44, 18 March 2007 (UTC)

Thanks - those are all good suggestions. I'll start work on them and strike them through as I think I've addressed them (feel free to comment further or unstrike them if you think the fixes are unsatisfactory). MastCell ^Talk 01:50, 18 March 2007 (UTC)

Other comments

Two quick comments:

• Could stand a few WP:DASH fixes. Do we have a guideline on ranges of percentages? "30%-60%" looks right and weird at the same time—I'd like guidance :)
• Caroli's syndrome should be linked or explained.

In my humble opinion, this article is GA quality, as is. Do you intend to nominate it, or expand and go straight to FA in due time? Fvasconcellos 16:51, 20 March 2007 (UTC)

I'll fix the dashes. I was hoping Caroli's had its own page (perhaps it should, but it doesn't), and I don't know enough to write one up without putting in some serious research which I just haven't had time for. Maybe for now I'll insert a short appositive description. I would eventually like to get it into FA status; hopefully it's not too far away. Perhaps I'll go ahead and nominate it for GA, since it may take quite some time at my current rate to address all of the little things that need to be done to get the article into really sparkling shape. MastCell ^Talk 16:57, 20 March 2007 (UTC)

Correction: there is an article, under Caroli disease. I've created the appropriate redirects. It's just a stub but at least fleshes out the disease a little. MastCell ^Talk 17:44, 20 March 2007 (UTC)

Actually, I think I've hit most of the suggestions, and I think there are no major omissions. I'm going to go ahead and nominate it for FA status, and see what the reception is. MastCell ^Talk 19:03, 20 March 2007 (UTC)