title: Survival of cholangiocarcinoma patients in northeastern Thailand after supportive treatment.
abstract: BACKGROUND
  Cholangiocarcinoma (CCA) is a very common cancer in Northeastern Thailand. Most CCA patients see a physician at a late stage when curative surgery is not possible. After diagnosis, they generally are treated by partial surgery/percutaneous drainage, chemotherapy and supportive treatment.
  
  
  OBJECTIVE
  This study aimed to assess the survival rates of CCA patients after supportive treatment.
  
  
  METHODS
  A retrospective cohort design was applied in this study. Data for 746 CCA patients were extracted from the hospital-based cancer registry of Srinagarind Hospital, Khon Kaen University. The patients were diagnosed (at least by ultrasonography) between 1 January, 2009 and 31 December, 2009 and then followed up for current status until 30 June, 2011. The cumulative survival rate was calculated by the Kaplan-Meier method, and independent prognostic factors were investigated using Cox regression.
  
  
  RESULTS
  The total follow-up time was 5,878 person-months, and the total number of deaths was 637. The mortality rate was therefore 10.8 per 100 person-year (95%CI : 10.1-11.7). The cumulative 3, 6, 9, 12 and 24 month survival rates were 59%, 39%, 31%, 24% and 14%, respectively. The median survival time after supportive treatment was 4 months. After adjusting for gender, age, stage, distant metastasis, histological grading and treatment, stage was a significant predictor of survival of CCA patients. Those in stage III and stage IV had a 6.78 fold higher mortality than the stage I and stage II cases (95% CI : 1.6-28.7).
  
  
  CONCLUSIONS
  It is very important to encourage patients to see health personnel at an early stage.
authors.affiliation: Department of Epidemiology, Faculty of Public Health, Khon Kaen University, Khon Kaen, Thailand E-mail : supannee@kku.ac.th.
authors.forename: Nut
authors.initials: N
authors.lastname: Thunyaharn
authors.forename: Supannee
authors.initials: S
authors.lastname: Promthet
authors.forename: Surapon
authors.initials: S
authors.lastname: Wiangnon
authors.forename: Krittika
authors.initials: K
authors.lastname: Suwanrungruang
authors.forename: Supot
authors.initials: S
authors.lastname: Kamsa-ard
mesh_terms: D001650:Bile Duct Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D001653:Bile Ducts, Intrahepatic / Q000473:pathology*; D018281:Cholangiocarcinoma / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D013785:Thailand