Natural History and Prognostic Factors of Advanced Cholangiocarcinoma without Surgery, Chemotherapy, or Radiotherapy: A Large-Scale Observational Study.
OBJECTIVE
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).


CONCLUSIONS
The median survival of advanced unresectable cholangiocarcinoma is dismal.
Park
Jongha
J
Division of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Kim
Myung-Hwan
MH
Kim
Kyu-Pyo
KP
Park
Do Hyun
DH
Moon
Sung-Hoon
SH
Song
Tae Jun
TJ
Eum
Junbum
J
Lee
Sang Soo
SS
Seo
Dong Wan
DW
Lee
Sung Koo
SK