Park J, Kim MH, Kim KP, et al. (2009) Natural History and Prognostic Factors of Advanced Cholangiocarcinoma without Surgery, Chemotherapy, or Radiotherapy: A Large-Scale Observational Study. Gut Liver, 3(4):298-305
Abstract
Result: 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).
Introduction
The aim of this study was to evaluate the “natural history”, which is the outcome from the time of diagnosis to death without therapeutic intervention, of cholangiocarcinoma.
Materials and Methods
Unresectability was determined with preoperative evaluation or open biopsy and the following clinical conditions were considered to be unresectable; 6,15-18 involvement of bilateral secondary radical hepatic ducts, invasion of main portal vein or proper hepatic artery, atrophy of one hepatic lobe with contralateral vascular invasion, atrophy of one hepatic lobe with contralateral tumor extension to secondary biliary confluence, invasion of secondary biliary confluence on one lobe and contralateral vascular invasion, or distant metastasis.
Discussion
As for intrahepatic cholangiocarcinoma, Shaib et al.25 reported a median survival of 57 days in patients not receiving any palliative treatment, which was shorter than that (median 90 days) of our study.
A few prognostic factors for survival were noted in our study. Serum albumin level above 3.0 g/dL was a favorable prognostic factor in both univariate and multivariate analysis for intrahepatic cholangiocarcinoma; whereas, it showed statistical significance only in univariate analysis for hilar cholangiocarcinoma. This factor has previously been attended by Nakeeb et al.9 who reported that preoperative serum albumin level was associated with longer survival in the surgical outcome of patients with cholangiocarcinoma.
In our study, multivariate analysis showed that distant metastasis was the only independently poor prognostic factor for intrahepatic cholangiocarcinoma (p＜0.001), whereas TNM staging for intrahepatic cholangiocarcinoma showed significant relationship with survival time (p=0.004) only on univariate analysis.
Abstract
Result: 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).
Introduction
The aim of this study was to evaluate the “natural history”, which is the outcome from the time of diagnosis to death without therapeutic intervention, of cholangiocarcinoma.
Materials and Methods
Unresectability was determined with preoperative evaluation or open biopsy and the following clinical conditions were considered to be unresectable; 6,15-18 involvement of bilateral secondary radical hepatic ducts, invasion of main portal vein or proper hepatic artery, atrophy of one hepatic lobe with contralateral vascular invasion, atrophy of one hepatic lobe with contralateral tumor extension to secondary biliary confluence, invasion of secondary biliary confluence on one lobe and contralateral vascular invasion, or distant metastasis.
Discussion
As for intrahepatic cholangiocarcinoma, Shaib et al.25 reported a median survival of 57 days in patients not receiving any palliative treatment, which was shorter than that (median 90 days) of our study.
A few prognostic factors for survival were noted in our study. Serum albumin level above 3.0 g/dL was a favorable prognostic factor in both univariate and multivariate analysis for intrahepatic cholangiocarcinoma; whereas, it showed statistical significance only in univariate analysis for hilar cholangiocarcinoma. This factor has previously been attended by Nakeeb et al.9 who reported that preoperative serum albumin level was associated with longer survival in the surgical outcome of patients with cholangiocarcinoma.
In our study, multivariate analysis showed that distant metastasis was the only independently poor prognostic factor for intrahepatic cholangiocarcinoma (p＜0.001), whereas TNM staging for intrahepatic cholangiocarcinoma showed significant relationship with survival time (p=0.004) only on univariate analysis.
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