title: Survival analysis of cholangiocarcinoma: a 10-year experience in Malaysia.
abstract: OBJECTIVE
  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.
  
  
  CONCLUSIONS
  Curative, margin-negative resection of early stage, well-differentiated intrahepatic tumors is associated with improved patient survival.
authors.affiliation: Faculty of Medicine, Universiti Tekno-logi MARA, Sg. Buloh Campus, 47000 Sg. Buloh, Selangor, Malaysia. dr_aramzy@yahoo.com
authors.forename: Ahmad Ramzi
authors.initials: AR
authors.lastname: Yusoff
authors.forename: Mohd Muzammil Abdul
authors.initials: MM
authors.lastname: Razak
authors.forename: Boon Koon
authors.initials: BK
authors.lastname: Yoong
authors.forename: R
authors.initials: R
authors.lastname: Vijeyasingam
authors.forename: Zuraidah Mahmud
authors.initials: ZM
authors.lastname: Siti
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001650:Bile Duct Neoplasms / Q000401:mortality* / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D001653:Bile Ducts, Intrahepatic / Q000473:pathology*; D018281:Cholangiocarcinoma / Q000401:mortality* / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008296:Malaysia; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016019:Survival Analysis; D015996:Survival Rate; D055815:Young Adult