188P - Survival and prognostic factors in cholangiocarcinoma: A single-center experience

Background

Survival and prognosis data in cholangiocarcinoma patients in routine clinical practice has been limited. This study aimed to determine the survival of cholangiocarcinoma patients and to investigate prognostic factors for survival in cholangiocarcinoma patients.

Methods

This cohort study retrospectively reviewed 158 records of cholangiocarcinoma patients treated in Oncology Unit, Department of Medicine, Rajavithi hospital from 1 January 2004 to 31 December 2017. Clinical characteristics, treatments, and outcomes were collected and analyzed.

Results

There were 158 patients whose median age was 58 years old while 69.6% of those had a good performance status (ECOG PS) of 0-1. The median survival time for all was 9.5 months (95% CI = 7.3-11.6) and the 1-year survival rate was 37.3%. After curative surgery (n = 49), 35 patients (71.4%) had tumor recurrence with the median disease-free survival of 8.81 months (95% CI = 6.93-10.68). Patients who received first-line palliative chemotherapy (n = 68) had the median progression-free survival of 4.3 months (95% CI = 3.51-5.10). The overall response rate to first-line chemotherapy was 7.3%. Variables analyzed by univariate analysis including ECOG PS of 3-4 (p < 0.001), neutrophil/lymphocyte ratio >/= 4 (p 0.004), intrahepatic cholangiocarcinoma (compared with hilar cholangiocarcinoma, p 0.005), distant metastasis in all sites (p < 0.001) and TNM stage IV disease (p < 0.001) were significant factors for shorter survival time. While surgical treatment, adjuvant chemotherapy and radiation, and palliative chemotherapy were significantly associated with better survival (p < 0.001). Multivariate analysis identified ECOG PS of 3-4 (p 0.001), intrahepatic type (p 0.001) and TNM stage IV disease (p 0.033) as independent poor prognostic factors for survival. Furthermore, receiving surgery and palliative chemotherapy administration (p < 0.001) were independent significant predictors associated with better survival compared to best supportive care alone.

Conclusions

Poor ECOG performance status of 3, intrahepatic cholangiocarcinoma type and TNM stage IV disease were adverse prognostic factors whereas surgical treatment and palliative chemotherapy had a crucial role in treatment for cholangiocarcinoma patients.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

Medical Oncology unit, Internal Medicine Department, Rajavithi Hospital.

Funding

Rajavithi Hospital.

Disclosure

All authors have declared no conflicts of interest.