Clinical Prognostic Factors and Treatment Outcomes for the Survival of Patients with Cholangiocarcinoma in the Eastern Region of Thailand

Charonpongsuntorn Chanchai; Piyanuch Piyasatit; Dittapol Muntham; Piyanant Chommaitree; Panunat Muangnoi

doi:10.31557/apjcc.2019.4.4.101-105

Authors

Charonpongsuntorn Chanchai
Piyanuch Piyasatit Department of Internal Medicine, HRH Princess Maha Chakri Sirindhorn Medical Center, Faculty of Medicine, Srinakharinwirot University, Nakhon Nayok, Thailand.
Dittapol Muntham Department of Mathematics, Faculty of Science and Technology, Rajamangala University of Technology Suvarnabhumi, Thailand.
Piyanant Chommaitree Department of Internal Medicine, HRH Princess Maha Chakri Sirindhorn Medical Center, Faculty of Medicine, Srinakharinwirot University, Nakhon Nayok, Thailand.
Panunat Muangnoi Department of Internal Medicine, HRH Princess Maha Chakri Sirindhorn Medical Center, Faculty of Medicine, Srinakharinwirot University, Nakhon Nayok, Thailand.

DOI:

https://doi.org/10.31557/apjcc.2019.4.4.101-105

Keywords:

Cholangiocarcinoma- Prognostic factor- treatment outcomes- overall survival

Abstract

Background: Cholangiocarcinoma (CCA) is an uncommon primary liver cancer worldwide but it commonly in Asia including Thailand. Although increasing incidence but the prognosis is poor and lethal cancer. Prognostic factors for CCA that affect survival outcomes are various due to a vary presentation and different diagnostic and therapeutic modalities. To date, satisfactory prognostic factors have not been understood.
Objective: This study evaluated clinical prognostic factors and treatment that affect survival outcomes in patients with CCA.
Methods: The CCA patients were identified from the database between January 2012 and December 2016. A retrospective review of 82 medical records was performed. Median follow time was more than 12 months. Survival outcome was estimated using Kaplan-Meier analysis. Demographic, clinical presentation, Laboratory, histopathological data and treatment modalities that affect survival were evaluated for prognostic factors relating to mortality by using univariate and multivariable statistical analysis.
Result: 82 patients were identified. Median overall survival was 11.1 months. An unresectable or metastatic CCA patient was 74.4% (61/82). Cox-regression univariate reports Higher Alkaline phosphatase level, Prolong Prothrombin time, Higher WBC count, Higher CA 19-9 level, Unresectable, Metastasis were identified as important clinical predictors of patient mortality. Treatment modalities factors that significantly affect survival outcome were Bile duct drainage, surgery, and palliative chemotherapy. A Poor prognostic outcome of survival depends on staging by resectability and metastasis (P < 0.01).
Conclusion: In this study identified that potential of surgery as the mainstay of treatment provided the best survival prognosis of patients with CCA. Treatment involving both bile duct drainage and chemotherapy also prolong CCA patient survival. Poor clinical prognostic factors which shorten survival are prolonging PT, higher WBC, ALP, and CA19-9.