title: Cutaneous metastasis of cholangiocarcinoma.
abstract: OBJECTIVE
  To investigate the clinical characteristics and prognostic factors of cutaneous metastasis of cholangiocarcinoma by a retrospective analysis of published cases.
  
  
  METHODS
  An extensive search was conducted in the English literature within the PubMed database using the following keywords: cutaneous metastasis or skin metastasis and cholangiocarcinoma or bile duct. The data of 30 patients from 21 articles from 1978 to 2014 were analyzed. Patient data retrieved from the articles included the following: age, gender, time cutaneous metastasis occurred, number of cutaneous metastases throughout life, sites of initial cutaneous metastasis, anatomic site, pathology and differentiation of cholangiocarcinoma, and immunohistochemical results of the cutaneous metastasis. The assessment of overall survival after cutaneous metastasis (OSCM) was the primary endpoint.
  
  
  RESULTS
  The median age at diagnosis of cutaneous metastasis of cholangiocarcinoma was 60.0 years (range: 35-77). This metastasis showed a predilection towards males, with a male to female ratio of 3.29. In 8 cases (27.6%), skin metastasis was the first sign of cholangiocarcinoma. Additionally, 18 cases (60.0%) manifested single cutaneous metastasis, while 12 cases (40.0%) demonstrated multiple skin metastases. In 50.0% of patients, the metastasis occurred in the drainage region, while 50.0% of patients had distant cutaneous metastases. The scalp was the most frequently involved region of distant skin metastasis, occurring in 36.7% of patients. The median OSCM of cholangiocarcinoma was 4.0 mo. Patient age and cutaneous metastatic sites showed no significant relation with OSCM, while male gender and single metastasis of the skin were associated with a poorer OSCM (hazard ratio: 0.168; P = 0.005, and hazard ratio: 0.296; P = 0.011, respectively).
  
  
  CONCLUSIONS
  The prognosis of cutaneous metastasis of cholangiocarcinoma is dismal. Both male gender and single skin metastasis are associated with a poorer OSCM.
authors.affiliation: Min Liu, Bai-Long Liu, Qiang Wang, Li-Hua Dong, Department of Radiation Oncology, the First Hospital, Jilin University, Changchun 130021, Jilin Province, China.
authors.forename: Min
authors.initials: M
authors.lastname: Liu
authors.affiliation: Min Liu, Bai-Long Liu, Qiang Wang, Li-Hua Dong, Department of Radiation Oncology, the First Hospital, Jilin University, Changchun 130021, Jilin Province, China.
authors.forename: Bai-Long
authors.initials: BL
authors.lastname: Liu
authors.affiliation: Min Liu, Bai-Long Liu, Qiang Wang, Li-Hua Dong, Department of Radiation Oncology, the First Hospital, Jilin University, Changchun 130021, Jilin Province, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Liu
authors.affiliation: Min Liu, Bai-Long Liu, Qiang Wang, Li-Hua Dong, Department of Radiation Oncology, the First Hospital, Jilin University, Changchun 130021, Jilin Province, China.
authors.forename: Liang
authors.initials: L
authors.lastname: Guo
authors.affiliation: Min Liu, Bai-Long Liu, Qiang Wang, Li-Hua Dong, Department of Radiation Oncology, the First Hospital, Jilin University, Changchun 130021, Jilin Province, China.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Wang
authors.affiliation: Min Liu, Bai-Long Liu, Qiang Wang, Li-Hua Dong, Department of Radiation Oncology, the First Hospital, Jilin University, Changchun 130021, Jilin Province, China.
authors.forename: Yan-Qiu
authors.initials: YQ
authors.lastname: Song
authors.affiliation: Min Liu, Bai-Long Liu, Qiang Wang, Li-Hua Dong, Department of Radiation Oncology, the First Hospital, Jilin University, Changchun 130021, Jilin Province, China.
authors.forename: Li-Hua
authors.initials: LH
authors.lastname: Dong
mesh_terms: D000328:Adult; D000368:Aged; D001650:Bile Duct Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D001653:Bile Ducts, Intrahepatic / Q000473:pathology*; D018281:Cholangiocarcinoma / Q000401:mortality / Q000556:secondary* / Q000628:therapy; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012737:Sex Factors; D012878:Skin Neoplasms / Q000401:mortality / Q000556:secondary* / Q000628:therapy; D013997:Time Factors; D016896:Treatment Outcome
keywords: Cholangiocarcinoma; Clinical characteristics; Cutaneous metastasis; Pathological features; Prognosis