Natural History and Prognostic Factors of Advanced Cholangiocarcinoma without Surgery, Chemotherapy, or Radiotherapy: A Large-Scale Observational Study.
- Author:
Jongha PARK
1
;
Myung Hwan KIM
;
Kyu pyo KIM
;
Do Hyun PARK
;
Sung Hoon MOON
;
Tae Jun SONG
;
Junbum EUM
;
Sang Soo LEE
;
Dong Wan SEO
;
Sung Koo LEE
Author Information
1. Division of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. mhkim@amc.seoul.kr
- Publication Type:Original Article
- Keywords:
Cholangiocarcinoma;
Natural history;
Carcinoembryonic antigen
- MeSH:
Adenocarcinoma;
Carcinoembryonic Antigen;
Cholangiocarcinoma;
Cohort Studies;
Comorbidity;
Epithelium;
Humans;
Liver Neoplasms;
Multivariate Analysis;
Natural History;
Neoplasm Metastasis;
Retrospective Studies;
Serum Albumin;
Cholangiocarcinoma
- From:Gut and Liver
2009;3(4):298-305
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND/AIMS: We aimed to evaluate survival time and prognostic factors in patients with advanced unresectable cholangiocarcinoma who have not received surgery, chemotherapy, or radiotherapy. METHODS: A total of 1,377 patients, who were diagnosed with primary cholangiocarcinoma between 1996 and 2002, were reviewed retrospectively according to the following inclusion criteria: histologically proven primary adenocarcinoma arising from the bile-duct epithelium, advanced unresectable stages, no severe comorbidity that can affect survival time, and no history of surgery, chemotherapy, or radiotherapy. RESULTS: Of the 1,377 cases reviewed, 330 patients complied with the inclusion criteria and were thus eligible to participate in this study; 203 had intrahepatic cholangiocarcinoma and 127 had hilar cholangiocarcinoma. The overall survival time of the entire cohort (n=330) was median 3.9 months (range; 0.2 to 67.1). The survival time was significantly shorter in the intrahepatic cholangiocarcinoma group (3.0+/-5.3 months) than in the hilar cholangiocarcinoma group (5.9+/-10.1 months; Kaplan-Meier survival analysis). Multivariate analysis revealed that distant metastasis was a poor prognostic factor for intrahepatic cholangiocarcinoma (p< 0.001), baseline serum albumin >3.0 g/dL was a favorable prognostic factor (p=0.02), and baseline serum carcinoembryonic antigen level >30 ng/mL was a poor prognostic factor for hilar cholangiocarcinoma (p=0.01). CONCLUSIONS: The median survival of advanced unresectable cholangiocarcinoma is dismal.
