title: Survival rate of extrahepatic cholangiocarcinoma patients after surgical treatment in Thailand.
abstract: BACKGROUND
  Intra- and extrahepatic cholangiocarcinoma (CCA) is the most common cancer in Thailand, especially in the northeast region. Most extrahepatic CCA patients consult a doctor at a late stage. Surgery is still the best treatment.
  
  
  OBJECTIVE
  The aim of this study was to evaluate survival rates and factors affecting survival in extrahepatic CCA patients following surgery at Srinagarind Hospital, Khon Kaen University, Thailand.
  
  
  METHODS
  A retrospective cohort study was conducted with 58 patients who were diagnosed and treated by surgical resection by the same surgeon at Srinagarind Hospital between 2005 and 2009. The patients were followed up until death or the end of the study (31 December, 2011). Survival rates were calculated by the Kaplan-Meier method, and the Cox proportional hazard model was used to identify independent prognostic factors.
  
  
  RESULTS
  The total follow-up time was 1,215 person-months, and the mortality rate was 50 per 100 person-years. The cumulative 1-, 3-, and 5-year survival rates were 62.1%, 21.7% and 10.8%, respectively. The median survival time after resection was 15 months. After adjusting for age, gender, lymph node metastasis and histological type, resection margin remained as a statistically significant prognostic factor for survival following surgery. A positive resection margin was associated with a 2.3-fold higher mortality rate than a negative margin.
  
  
  CONCLUSIONS
  Resection margins are important prognostic factors affecting survival of extrahepatic CCA patients after surgery. A negative resection margin can reduce the mortality rate by 56%.
authors.affiliation: Department of Epidemiology, Faculty of Public Health, Khon Kaen University, Thailand.
authors.forename: Pisit
authors.initials: P
authors.lastname: Pattanathien
authors.forename: Narong
authors.initials: N
authors.lastname: Khuntikeo
authors.forename: Supannee
authors.initials: S
authors.lastname: Promthet
authors.forename: Supot
authors.initials: S
authors.lastname: Kamsa-Ard
mesh_terms: D000328:Adult; D001650:Bile Duct Neoplasms / Q000473:pathology / Q000601:surgery*; D017734:Bile Ducts, Extrahepatic; D018281:Cholangiocarcinoma / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D018365:Neoplasm, Residual; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D015996:Survival Rate; D013785:Thailand