Prognostic Factors of Cholangiocarcinoma After Surgical Resection: A Retrospective Study of 293 Patients
Zhi-yuan Mao, Xiao-chuan Guo, Dan Su, Li-jie Wang, Ting-ting Zhang, Li Bai
Department of Oncology, General Hospital of Air Force, Beijing, China (mainland)
Med Sci Monit 2015; 21:2375-2381
Cholangiocarcinoma is one of the most common malignancies in China. Surgical resection is the only treatment option; however, diagnosis at advanced stage precludes surgery. Comprehensive knowledge of prognostic markers is missing. Hence, the aim of this study was to determine clinicopathological indexes that would be indicative of prognosis in post-operative cases of cholangiocarcinoma.
MATERIAL AND METHODS: A retrospective analysis of 293 cases of cholangiocarcinoma patients attending the 301 Military Hospital in Beijing, China between January 2004 and December 2010 were included in the study. The patients had follow-up history until August 2012. Cox proportional hazards model analysis was performed to identify indexes of prognosis. All indicators were analyzed by univariate and multivariate analysis.
RESULTS: The median follow-up time was 55.90 months, with recurrence and metastasis in 162 cases (55.3%) and death in 223 cases (76.1%). The 1-year, 3-year, and 5-year survival rates were 71.7%, 38.2%, and 10.6%, respectively. The independent risk factors of overall survival were degree of tumor differentiation, TNM stage, surgical margin, intraoperative blood transfusion, tumor location, alkaline phosphatase levels in blood, and relapse.
CONCLUSIONS: Good prognosis in cholangiocarcinoma patients is indicated by highly differentiated tumor, early stages of TNM staging, no resection margin invaded, no intraoperative blood transfusion, intrahepatic tumor, normal alkaline phosphatase levels, and no relapse.
Keywords: Adult, Aged, 80 and over, Bile Duct Neoplasms - surgery, China - epidemiology, Cholangiocarcinoma - surgery, Prognosis, Survival Rate