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

• Published in: Gut and liver Vol. 3; no. 4; pp. 298 - 305
• Main Authors: Park, Jongha, Kim, Myung-Hwan, Kim, Kyu-pyo, Park, Do Hyun, Moon, Sung-Hoon, Song, Tae Jun, Eum, Junbum, Lee, Sang Soo, Seo, Dong Wan, Lee, Sung Koo
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Society of Gastroenterology; the Korean Society of Gastrointestinal Endoscopy; the Korean Association for the Study of the Liver; the Korean Society of Neurogastroenterology and Motility; Korean Association for the Study of Intestinal Diseases; Korean College of Helicobacter and Upper Gastrointestinal Research; Korean Society of Pancreatobiliary Diseases 01.12.2009; Gastroenterology Council for Gut and Liver; 거트앤리버 소화기연관학회협의회
• Subjects: carcinoembryonic antigen; cholangiocarcinoma; natural history; Original; 내과학; Carcinoembryonic antigen; Cholangiocarcinoma; Natural history
• ISSN: 1976-2283; 2005-1212; 2005-1212
• DOI: 10.5009/gnl.2009.3.4.298

We aimed to evaluate survival time and prognostic factors in patients with advanced unresectable cholangiocarcinoma who have not received surgery, chemotherapy, or radiotherapy. 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. 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). The median survival of advanced unresectable cholangiocarcinoma is dismal.