Prognostic factors in patients with advanced cholangiocarcinoma: role of surgery, chemotherapy and body mass index.
OBJECTIVE
To study the factors that may affect survival of cholangiocarcinoma in Lebanon.


METHODS
A retrospective review of the medical records of 55 patients diagnosed with cholangio-carcinoma at the American University of Beirut between 1990 and 2005 was conducted. Univariate and multivariate analyses were performed to determine the impact of surgery, chemotherapy, body mass index, bilirubin level and other factors on survival.


RESULTS
The median survival of all patients was 8.57 mo (0.03-105.2). Univariate analysis showed that low bilirubin level (< 10 mg/dL), radical surgery and chemotherapy administration were significantly associated with better survival (P = 0.012, 0.038 and 0.038, respectively). In subgroup analysis on patients who had no surgery, chemotherapy administration prolonged median survival significantly (17.0 mo vs 3.5 mo, P = 0.001). Multivariate analysis identified only low bilirubin level < 10 mg/dL and chemotherapy administration as independent predictors associated with better survival (P < 0.05).


CONCLUSIONS
Our data show that palliative and postoperative chemotherapy as well as a bilirubin level < 10 mg/dL are independent predictors of a significant increase in survival in patients with cholangiocarcinoma.
Division of Hematology- Oncology, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, 110 72020, Lebanon.
Mirna H
MH
Farhat
Ali I
AI
Shamseddine
Ayman N
AN
Tawil
Ghina
G
Berjawi
Charif
C
Sidani
Wael
W
Shamseddeen
Kassem A
KA
Barada
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001650:Bile Duct Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D001653:Bile Ducts, Intrahepatic / Q000187:drug effects* / Q000378:metabolism / Q000473:pathology / Q000601:surgery*; D001662:Biliary Tract Surgical Procedures; D001663:Bilirubin / Q000378:metabolism; D015992:Body Mass Index; D017024:Chemotherapy, Adjuvant; D018281:Cholangiocarcinoma / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D007861:Lebanon / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D001663:Bilirubin