Wikipedia:Featured article candidates/Cholangiocarcinoma

The following is an archived discussion of a featured article nomination. Please do not modify it. Subsequent comments should be made on the article's talk page or in Wikipedia talk:Featured article candidates. No further edits should be made to this page.

The article was promoted 16:30, 31 March 2007.

Cholangiocarcinoma

Having worked on developing this article and requesting a peer review (which provided many helpful suggestions), I think it's now ready in terms of completeness, stability, referencing, and style to be considered for featured-article status. I'm happy to address any deficiencies or suggestions mentioned here to improve the article further. This is essentially a self-nomination. MastCell ^Talk 19:08, 20 March 2007 (UTC)[reply]

Comment Except for the staging section, metastasis isn't mentioned anywhere. Metastasis significantly influences prognosis and operability so I think this should be added (even though cholangiocarcinoma rarely has metastasized at the time of presentation). --WS 22:39, 20 March 2007 (UTC)[reply]

Distant metastases are rare, and it seems that it doesn't really matter if you have locally advanced disease or metastatic disease; basically, if the tumor can't be resected for whatever reason, the outcome is poor. Do you have refs for metastasis specifically affecting prognosis? I haven't found any but I'll keep looking. MastCell ^Talk 00:11, 23 March 2007 (UTC)[reply]

Only for lymph node metastasis: PMID 17278119 PMID 17006609 PMID 11224627 But it is also interesting to mention what the most common sites of metastasis are and like you say that distant metastasis is rare. --WS 13:00, 25 March 2007 (UTC)[reply]

Another comment: after resection a five year survival of 17% is mentioned. Both emedicine and the oxford textbook of surgery pu it at 40%. Any idea which would be more correct? --WS 23:02, 20 March 2007 (UTC)[reply]

Done There are a range of survival statistics, depending on the location of the tumor and which series you look at. I've expanded the section considerably to reflect the varying estimates of long-term survival - please take a look. MastCell ^Talk 00:11, 23 March 2007 (UTC)[reply]

Better now. Support --WS 13:00, 25 March 2007 (UTC)[reply]

Well done. The lead could use some additional context to make it more accessible to the average reader. A large percentage of readers would not know where the bile ducts are or what they are. The second sentence tell us they're in or near the liver, but that would be better in the first sentence to ease the reader in. The picture helps, but not quite enough. In the sentence mentioning the left and right hepatic ducts that wording is really only useful to medical practitioners. It's particularly important that the lead is as accessable to everyone as possible. Need to reduce the number of short, one and two sentence paragraphs. There are several throughout. Otherwise looks quite good and I'd support with all that fixed. - Taxman ^Talk 17:37, 23 March 2007 (UTC)[reply]

I gave it a shot. See what you think. MastCell ^Talk 20:38, 23 March 2007 (UTC)[reply]

Still needs much more on merging or expanding the short paragraphs, I think I saw about 6 or 7. Now the lead has one. But that simple fix did make the lead more approachable. Now just expand it a little bit. - Taxman ^Talk 22:07, 23 March 2007 (UTC)[reply]

I've gone through and tried to merge these. I think the short paragraphs don't look as awful or eye-catching to me because I'm using an 800x600 monitor (stone age, I know). It only takes a few sentences to fill the screen. If you see some more that are sticking out to you, feel free to merge them. MastCell ^Talk 22:33, 23 March 2007 (UTC)[reply]

Comments very good, needs a couple of tweaks though:
- When you say 'higher prevalence among Asian people', you should specify that (I presume) you mean people in Asia, not people of Asian ethnicity who live elsewhere.
- I didn't think of this before, but the existence of HIV infection as a risk factor is only mentioned as a possible explanation for increasing rate of occurrence, but it's not strongly supported by the risk factors section. Is the mechanism for this known?
- Did you manage to dig up any images? The pathophysiology section would be clearer with some pictures.
- The very last sentence is very long and stringy; break it up into two (or note the use of a semicolon ;) Opabinia regalis 00:54, 24 March 2007 (UTC)[reply]

Done I think. Take a look. As far as HIV, it has only been mentioned as a risk factor in one (fairly large) study. It did hold up as significant in multivariate analysis, but I think there's still a question as to whether HIV is directly involved or whether it's a marker for increased risk of hepatitis B/C and cirrhosis, which are clearly linked to cholangiocarcinoma. The mechanism by which HIV might predispose one to develop a cholangiocarcinoma is unknown, as far as I could find in my reading. Images: unfortunately, so far we've got what we've got, unless someone out there has something to upload. MastCell ^Talk 23:40, 26 March 2007 (UTC)[reply]

Support with the suggestion that the epidemiology section call HIV a 'potential risk factor' or somesuch. Opabinia regalis 04:50, 28 March 2007 (UTC)[reply]

Done MastCell ^Talk 15:35, 30 March 2007 (UTC)[reply]

Comments Thorough, well-written article, nicely organized into sections and with neat, uniform citations. Here are a few suggestions, though, which are really just some loose ideas, because the article is very good as it is currently.
- The article was understandable to a reader as unfamiliar with the subject as myself, but, as FAs are intended for a wide readership, I'd still recommend a few tweaks for accessibility. Perhaps more in-article explanation of technical terms would help. It's not a major concern, though, and the wiki-linking of technical terms already present in the article is very helpful.
- The only national incidence statistics under the "Epidemiology" section are for the United States. Perhaps more data from such countries as Canada, the U.K., and Australia would be useful for comparison (although the difference between incidence in the Western and Eastern world is clear). Perhaps these data could be assembled into a table, which could be right- or left-aligned, if there was a concern that integrating this information into the section's prose would interrupt its flow.
- Some illustrations of particular locations where cancer can develop in the bile ducts might help readers to better understand the points relating to the different effects that these different locations can have. This could be as simple as taking the bile duct diagram and adding a coloured dot. -Severa (!!!) 01:52, 29 March 2007 (UTC)[reply]

Done for the table. It's my first table, so I'm sure if it helps or hinders the article, but we'll see. I tried to de-jargon the article a bit. As far as the illustration, I've seen a couple of beautiful illustrations of the various sites at which cholangiocarcinoma can arise, but all such images I've seen are copyright and not freely available. I don't have the skills to create one on my own, but I'll keep looking. MastCell ^Talk 16:45, 30 March 2007 (UTC)[reply]

Looks good, very helpful addition. Support. Although further reccomendations for the table would be to rearrange the country statistics in alphabetical order, formalize abbreviations like "U.S.A." to the full country name, and wikilink the names of the countries. This is the standard I've witnessed on articles that feature by-country tabulations of information. Maybe if you asked around WikiProject Medicine, someone might be able to help you find an illustration, or even create one. I'd do it myself, but I'm afraid my illustration skills are far too amateur to be of any use in creating anatomical diagrams. -Severa (!!!) 21:09, 30 March 2007 (UTC)[reply]

The above discussion is preserved as an archive. Please do not modify it. Subsequent comments should be made on the article's talk page or in Wikipedia talk:Featured article candidates. No further edits should be made to this page.