Survival analysis of cholangiocarcinoma: a 10-year experience in Malaysia

Abstract

Aim: To investigate the clinical features and survival of patients treated for cholangiocarcinoma in our institution and to analyze the factors affecting their survival.

Methods: This retrospective cohort study assessed patients diagnosed with cholangiocarcinoma between January 1997 and December 2007 at the University Malaya Medical Centre in Malaysia. The clinical data and associated outcomes were collected using a structured proforma.

Results: Of the 69 patients diagnosed with cholangiocarcinoma, 38 (55%) were male; mean patient age was 61 years. Twelve patients (17%) had intrahepatic, 38 (55%) had perihilar and 19 (28%) had distal tumors. Only 12 patients underwent curative surgery, including seven R0 resections. Only one patient died within 30 d after surgery. The overall median survival was 4 mo, whereas the median survival of R0 resected patients was 16 mo. The overall 1-, 2- and 3-year cumulative survival rates were 67%, 17% and 17%, respectively. Survival rates were significantly associated with curative resection (P = 0.002), intrahepatic tumor (P = 0.003), negative margin status (P = 0.013), early tumor stage (P = 0.016), higher tumor differentiation (P = 0.032) and absence of jaundice (P = 0.038). Multivariate analysis showed that tumor location was a significant independent predictor of patient survival.

Conclusion: Curative, margin-negative resection of early stage, well-differentiated intrahepatic tumors is associated with improved patient survival.

Keywords: Bile duct tumor; Cholangiocarcinoma; Malaysia; Surgery.

Figures

Figure 1

Overall survival by types of cholangiocarcinoma regardless of surgery or not, P = 0.027.

Figure 2

Cumulative survival curves after curative resection, P = 0.002.

Figure 3

Cumulative survival curves after resection according to histologic margin clearance, P = 0.013.

Figure 4

Overall survival according to degree of tumour differentiation, P = 0.032.