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KMID : 1188320090030040298
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Gut and Liver
2009 Volume.3 No. 4 p.298 ~ p.305
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Natural History and Prognostic Factors of Advanced Cholangiocarcinoma without Surgery, Chemotherapy, or Radiotherapy: A Large-Scale Observational Study
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Park Jong-Ha
Kim Myung-Hwan
Kim Kyu-Pyo
Park Do-Hyun
Moon Sung-Hoon
Song Tae-Jun
Eum Jun-Bum
Lee Sang-Soo
Seo Dong-Wan
Lee Sung-Koo
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Abstract
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Backgrounds/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).
Conslusions: The median survival of advanced unresectable cholangiocarcinoma is dismal.
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KEYWORD
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Cholangiocarcinoma, Natural history, Carcinoembryonic antigen
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