Survival Time of Cholangiocarcinoma Patients in Khon Kaen Hospital

Abstract

Cholangiocarcinoma is a common malignancy in Northeastern Thailand and important cause of cancer related death. This study aimed to evaluate the overall survival time and associated factors among cholangiocarcinoma patients at Khon Kaen hospital. A descriptive study design was conducted by reviewing the medical records of patients diagnosed and treated for cholangiocarcinoma between January 1, 2018, and December 31, 2019. Data were extracted from the hospital’s electronic medical records system. Survival time and related factors were analyzed using inferential statistics, including Kaplan–Meier survival analysis, cox regression and log-rank test.

Results: Among 242 patients, the median overall survival (median OS) was 3.77 months. At the time of diagnosis, 106 patients (43.80%), were assessed as suitable for palliative care, while 59 patients (24.38%) were deemed to have the potential for curative resection. Among those eligible for surgery, only 35 patients (14.46%) actually underwent surgery. In the surgical group, the median OS was 16.20 months. Meanwhile, the average survival time for patients receiving only biliary drainage, palliative chemotherapy, or supportive care alone had median survival times of 4.57, 13.97, and 2.60 months, respectively. Factors associated with survival included undergoing surgery (compared to other treatment methods), with a hazard ratio (HR) of 0.27 (95% CI; 0.18-0.42, p<0.001); CA 19-9 tumor marker level ³166 U/ml, HR = 1.97 (95% CI: 1.45–2.69, p < 0.001); tumor location at the hepatic hilum, HR = 1.33 (95% CI; 1.01-1.74, p=0.043); and R0 resection with no lymph node metastasis (R0N0), HR = 0.03 (95% CI; 0.004-0.20, p<0.001).

          Conclusion: The overall survival time of patients with cholangiocarcinoma remains quite low, at 3.77 months. The factors associated survival time were surgical treatment and the absence of lymph node metastasis on histopathology, which was associated with the best outcomes. Therefore, early detection of the disease is crucial.