Clinical outcomes of second-line chemotherapy and prognostic factor analysis in patients with unresectable or metastasis cholangiocarcinoma at Sunpasitthiprasong Hospital: Retrospective cohort analytical study.
Keywords:
Cholangiocarcinoma, chemotherapy, FOLFOXAbstract
Abstract
Background: Cholangiocarcinoma is a significant health problem in the northeastern region of Thailand, where patients often present at advanced stages of the disease. The standard treatment is chemotherapy with a conventional regimen. However, some patients do not respond or experience recurrence, leading to the use of second-line chemotherapy with the FOLFOX regimen. There is currently limited data about effectiveness of FOLFOX in Thailand. This study aims to evaluate the outcomes of FOLFOX treatment and identify prognostic factors associated with survival in patients with unresectable cholangiocarcinoma.
Materials and Methods: This retrospective study reviewed medical records of patients with advanced, unresectable cholangiocarcinoma who received second-line chemotherapy with the FOLFOX regimen at Sunpasitthiprasong Hospital between January 1, 2018, and January 31, 2023. Data on patient demographics, biochemical analysis, and radiological imaging were collected. Overall survival was analyzed using the Kaplan-Meier method, and prognostic factors were analyzed using both univariate and multivariate Cox proportional hazards models.
Results: A total of 140 patients were included in the study, with a median follow-up time of 14.52 months. The median overall survival (OS) was 6 months (95% CI: 5.3-6.77), and the median progression-free survival (PFS) was 3 months (95% CI: 2.6-3.4). Multivariable analysis revealed that poor prognostic factors is no previous surgery, metastasis to three or more organs,
