Farhat MH, Shamseddine AI, Tawil AN, Berjawi G, Sidani C, Shamseddeen W, Barada KA. Prognostic factors in patients with advanced cholangiocarcinoma: Role of surgery, chemotherapy and body mass index. World J Gastroenterol 2008; 14(20): 3224-3230 [PMID: 18506930 DOI: 10.3748/wjg.14.3224]
Corresponding Author of This Article
Kassem Barada, MD, Division of Gastroenterology, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, 110 72020, Lebanon. kb02@aub.edu.lb
Article-Type of This Article
Rapid Communication
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World J Gastroenterol. May 28, 2008; 14(20): 3224-3230 Published online May 28, 2008. doi: 10.3748/wjg.14.3224
Table 1 Demographic and clinical data of 55 patients with cholangiocarcinoma
Number of patients (%)
Age (mean ± SD)
62.6 ± 13
Range (yr)
28-91
61/39
Male/Female
34/22
Diabetes (Yes/No)
14/41
25/75
BMI (kg/m2)
< 25
18
35
25-30
16
31
≥ 30
18
35
Not available
3
History of cholelithiasis (Yes /No)
17/38
31/69
Clinical manifestations
Jaundice
40
72.7
Dark urine
34
61.8
Weight loss
24
43.6
Abdominal pain
24
43.6
Total bilirubin
< 10 mg/dL
27
49
≥ 10 mg/dL
17
31
Missing
11
20
AJCC staging
I
1
II
1
III
0
IV
49
89
Missing
4
Surgery
Yes
21
38
No
34
62
Adjuvant chemotherapy
Yes
14
25
No
41
75
Table 2 Tumor location, size, grade, nodal and margin status and relation to survival in patients with cholangiocarcinoma
n
Median survival (95% CI)
P
Location
Intrahepatic
10
6.23 (0.76-11.7)
0.68
Perihilar
18
11.47 (6.73-16.2)
Distal
21
9.17 (0.52-17.8)
Not available
6
Size
< 3 cm
19
3.47 (1.9-5.0)
0.31
≥ 3 cm
13
11 (4.13-17.87)
Not available
23
13
Grade
Poor
4
16.96 (8.9-25.0)
0.31
Moderate
15
11 (2.77-19.2)
Well
8
13 (0-31)
Missing
28
Margin status
Positive
7
9.9 (4.6-15.19)
0.90
Negative
14
14.3 (5.5-23.1)
Vascular invasion
Yes
7
22 (4.9-39.2)
0.78
No
14
10.2 (4.04-16.42)
Perineural involvement
Yes
10
6.2 (4.9-7.5)
0.66
No
13
11 (5.8-16.2)
Table 3 Association between clinical variables and survival in patients with cholangiocarcinoma
Variable (n)
Median survival (mo)
P (Univariate)
Age
< 50 (11)
10.23 (1.87-18.6)
0.410
≥ 50 (44)
9.17 (3.9-14.4)
Gender
Male (33)
9.17 (3.8-14.5)
0.386
Female (22)
9.9 (0.4-19.4)
Bilirubin
< 10 (27)
9.9 (3.1-16.7)
0.012
≥ 10 (17)
2.87 (1.2-4.5)
BMI
< 25 (18)
13.0 (8.5-17.6)
0.412
25-30 (16)
7.0 (3.2-10.8)
≥ 30 (18)
4.0 (0.5-7.6)
Surgery
Yes (21)
10.23 (4.82-15.64)
0.038
No (34)
8.7 (1.8-15.6)
Type of surgery
Whipple (6)
16.6 (0.0-39.4)
0.988
Hepatic lobectomy (6)
10.2 (3.9-16.6)
Bile duct excision (9)
14.3 (8.5-20.1)
Metastasis
Yes (19)
7.07 (0.0-15.83)
0.256
No (36)
9.09 (6.05-13.75)
Stenting
Yes (24)
9.9 (0.45-19.35)
0.930
No (32)
9.16 (4.6-13.7)
Chemotherapy
Yes (14)
16.96 (11.5-22.4)
0.038
No (41)
6.2 (0-12.9)
Chemotherapy in unresected patients
Yes (8)
17 (12.76-21.18)
0.001
No (25)
3.5 (1.12-5.8)
Table 4 Multivariate analysis of prognostic factors in patients with advanced cholangiocarcinoma
Hazard’s ratio
95% CI
P
Bilirubin
< 10
1
1.13-0.52
0.023
≥ 10
2.421
Surgery
No
1
0.27-1.38
0.238
Yes
0.611
Chemotherapy
No
1
0.16-0.92
0.038
Yes
0.383
Citation: Farhat MH, Shamseddine AI, Tawil AN, Berjawi G, Sidani C, Shamseddeen W, Barada KA. Prognostic factors in patients with advanced cholangiocarcinoma: Role of surgery, chemotherapy and body mass index. World J Gastroenterol 2008; 14(20): 3224-3230