Factors affecting survival outcome after curative resection for cholangiocarcinoma patients
Keywords:
Cholangiocarcinoma, Curative resection, Survival rate, Prognostic factorsAbstract
Cholangiocarcinoma (CCA) is the most common primary liver cancer in the northeast of Thailand where it has its highest incidence worldwide and where it is one of the major causes of death. Curative surgery remains the best method of treatment. The objective of this study was to evaluate the survival rate and factors affecting survival outcome after curative resection for CCA patients. A retrospective cohort study was conducted in 126 with histologically confirmed CCA who underwent curative resection at Roi-Et hospital during January 1, 2014, to December 31, 2017. The patients were followed up until death or the end of the study (31 December 2018). Postoperative survival rates were performed by the Kaplan-Meier method, and the Cox proportional hazard model was used to identify independent prognostic factors. The total follow-up time was 4,085 person-month; and the mortality rate was 17.0 per 100 person-year (95%CI: 13.1-22.0). The cumulative 1- and 4- year survival rates were 97.6% (95%CI: 92.8-99.2) and 52.9% (95%CI: 41.1-63.5), respectively. The median survival time after curative resection was 50.6 months (95%CI: 33.9-54.3). After adjusting for age, gender, histological grading, macroscopic classification, and resection margin, only lymph node metastasis was a statistically significant prognostic factor after curative resection. Lymph node metastasis was associated with a 2.85 folds higher mortality rate than those not metastasis (HR= 2.85; 95%CI: 1.48-5.47; p-value=0.002). Thus lymph node metastasis was an important prognostic factor affecting survival outcome after curative resection for CCA patients and negative lymph node metastasis could reduce the mortality rate by 65.0%.
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