Clinical Research
Copyright ©2005 Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Mar 28, 2005; 11(12): 1779-1784
Published online Mar 28, 2005. doi: 10.3748/wjg.v11.i12.1779
Prognostic analysis of surgical treatment of peripheral cholangiocarcinoma: Two decades of experience at Chang Gung Memorial Hospital
Yi-Yin Jan, Chun-Nan Yeh, Ta-Sen Yeh, Tse-Ching Chen
Yi-Yin Jan, Chun-Nan Yeh, Ta-Sen Yeh, Department of Surgery, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan, China
Tse-Ching Chen, Department of Pathology, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan, China
Author contributions: All authors contributed equally to the work.
Correspondence to: Yi-Yin Jan, M.D., FACS, Department of Surgery, Chang Gung Memorial Hospital, 5, Fu-Hsing Street, Kwei-Shan, Taoyuan, Taiwan, China. ycn@adm.cgmh.org.tw
Telephone: +886-3-3281200-3219 Fax: +886-3-3285818
Received: October 13, 2004
Revised: October 14, 2004
Accepted: November 29, 2004
Published online: March 28, 2005
Abstract

AIM: To analyze the prognostic factors influencing the overall survival of peripheral cholangiocarcinoma (PCC) patients undergoing surgical treatment during 25 years at a single institution.

METHODS: This study retrospectively reviewed prospectively collecting data about 373 patients with histologically proven PCC who underwent surgical treatment between 1977 and 2001.

RESULTS: Three hundred and seventy-three PCC patients (159 men and 214 women) underwent surgical treatment from 1977 to 2001. Among them, 187 PCC patients underwent hepatectomy and 135 had curative resection (curative resectability rate: 36.2%). The follow-up duration ranged from 1.05 to 167.6 mo (mean/median = 14.1/7.2 mo). Overall cumulative survival rates at 1, 3, and 5 years were 32.5%, 9.2%, and 4.1%, respectively. Univariate log-rank analysis identified the following as adverse influences on overall survival: presence of symptoms, absence of mucobilia, elevated CEA and CA 19-9 levels, non-papillary tumor type, receiving non-hepatectomy, advanced tumor staging, lack of post-operative chemotherapy, and radiotherapy. Meanwhile, multivariate Cox’s proportional hazard analysis demonstrated that absence of mucobilia, non-papillary tumor type, advanced tumor staging, non-hepatectomy, and lack of post-operative chemotherapy were the five independent prognostic factors that adversely affected overall survival.

CONCLUSION: Favorable overall survival of PCC patients undergoing surgical treatment depends on early tumor stage, presence of mucobilia, papillary tumor type, hepatic resection, and post-operative chemotherapy.

Keywords: Prognostic factor, Surgical treatment, Peripheral cholangiocarcinoma