P-153 - Impact of comorbidity on survival of patients with cholangiocarcinoma

Date 04 July 2015
Event WorldGI 2015
Session Posters
Topics Hepatobiliary Cancers
Cancer in Special Situations
Presenter E. Inga
Citation Annals of Oncology (2015) 26 (suppl_4): 1-100. 10.1093/annonc/mdv233
Authors E. Inga1, E. Casaut2, M.G. Padilla2, M. Gonzalez3, M. Miranda2, J. Gomez-Ulla2
  • 1Hospital Universitario Infanta Cristina, Badajoz/ES
  • 2Hospital Infanta Cristina, Badajoz/ES
  • 3Resident of Oncology, Badajoz/ES

Abstract

Introduction

Cholangiocarcinoma is the second most common primary malignant tumor of the liver. It accounts for about 3% of all gastrointestinal cancers globally.

Cholangiocarcinoma (CCA) is a progressively fatal disease that generally occurs due to malignant transformation of hepatic biliary cholangiocytes. The incidence of CCA has been increasing worldwide and there is an urgent requirement for effective diagnosis and treatment strategies against this devastating disease. Different factors including liver-fluke infestation, viral hepatitis, exogenous nitrosamine-mediated DNA damage, and chronic inflammation have been linked to CCA genesis.

Our primary endpoint is determinate the impact of comorbidity on survival in a series of patients with hilar cholangiocarcinoma and evaluate prognostic factors.

Methods

A total of 51 patients diagnosed with cholangiocarcinoma between 2010 and 2014 were analyzed. We reviewed retrospectively according to the following inclusion criteria: histologically proven primary adenocarcinoma arising from the bile-duct epithelium. Data of risk factors, presentation, management, classification and outcome were assessed by clinical chart review. Comorbidity was evaluated using Charlson comorbidity index (CCI). The American Joint Committee on Cancer (AJCC) 2003 criteria were used for TNM (tumor, node, metastases), and used the Bismuth-Corlette in classification of perihilar cholangiocarcinoma. Statistical analysis was performed using SPSS version15.

Results

At moment of diagnosis mean age was 66 years (range 40 to 86) and there were 20 females and 31 males.

Jaundice and abdominal pain were the most common symptoms, both of them was presented in 70.2%.

37% showed risk factors for the development to cholangiocarcinoma.

A family history of cancer was reported in 8 patients (16%).

The overall survival time was 18 ± 3 moths, with 1 and 2 year survival rates of 45% and 25% respectively. The median CCI score was 3 (range 0 to 3). Three patients (8.1%) had no comorbidity (CCI score of 0), 17 (45.9%) had a high comorbidity (CCI score ≥3). The median survival in patient with a Score of 1 was longer than that in patients with CCI high score (24 ± 2.1 months versus 3 ± 1.3 months, P = 0.02).

Conclusion

The presence and number of comorbid conditions (assessed by the CCI) in patients' diagnoses with perihilar cholangiocarcinoma showed be independent factors of unfavorable prognosis.

So that, comorbidity evaluation instruments should be applied in the clinical management of such patients.