Clinical factors associated with the survival of patients with intrahepatic cholangiocarcinoma

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• 作者：Chun-Fu Ting^a ; Wen-Hsin Huang^a ; ^b ; Chun-Lung Feng^a ; Cheng-Ju Yu^a ; Cheng-Yuan Peng^a ; ^b ; Wen-Pang Su^a ; Hsueh-Chou Lai^a ; Ken-Sheng Cheng^a ; Po-Heng Chuang^a ; Jung-Ta Kao^a ; ^b ; ^{garrydarkao@gmail.com" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Cholangiocarcinoma ; Intrahepatic ; Liver function ; Therapeutic modality
• 刊名：Advances in Digestive Medicine
• 出版年：2016
• 出版时间：March 2016
• 年：2016
• 卷：3
• 期：1
• 页码：11-17
• 全文大小：515 K

文摘

Intrahepatic cholangiocellular carcinoma (ICC) is an uncommon but lethal cancer. The aim of this study is to assess the factors affecting the survival of ICC patients and to evaluate the benefit of these factors when various therapeutic modalities are used.

Methods

Between October 2007 and June 2012, 66 ICC cases among 2255 liver cancer patients were identified by pathology and divided into two groups: Group I (surgery group; n = 17) and Group II (nonsurgery group; n = 49). Group II was further divided into Group IIa (those receiving palliative treatment; n = 19) and Group IIb (no treatment received; n = 30). Factors affecting patient survival over the study period were assessed (3- and 6-month results were reported) and therapeutic benefits identified within each of the groups were evaluated.

Results

Of the 66 patients identified (male/female = 36/30), 10.6% (7/66) were in the early stages of illness. Overall, the mean patient survival duration was 3.50 ± 0.92 months (1.69–5.31 months). The mean survival duration of Group I patients was 10.50 ± 2.84 months (4.94–16.06 months). The mean survival duration of Group II patients was 3.50 ± 0.65 months (2.24–4.76 months) with Group IIa patients surviving on average 9.50 ± 3.27 months (3.10–15.90 months) and Group IIb patients surviving on average 1.50 ± 0.12 months (1.26–1.74 months). Better survival outcomes were observed in the groups receiving treatment, Group I and Group IIa, than in Group Iib, which did not receive treatment [9.50 ± 1.73 months (6.12–12.89 months) vs. 1.50 ± 0.12 months (1.26–1.74 months), p < 0.001]. Lower albumin, higher bilirubin, higher CA19-9, advanced tumor stage, and no treatment were identified as important predictors of patient mortality at the 3- and 6-month time-points. These factors remained relevant throughout the entire study period (p = 0.002, 0.029, 0.027, 0.028, < 0.001, respectively).

Conclusion

This study identified surgery as the treatment that provided the best survival prognosis for patients with ICC. Treatment involving either chemotherapy or radiotherapy could also prolong ICC patient survival. Better liver preservation, lower CA19-9, and less aggressive tumor conditions were identified as factors which play crucial roles in enhancing patient survival.