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Clinical features and survival outcome of locally advanced extrahepatic cholangiocarcinoma.

Lee SJ, Kwon W, Kang MJ, Jang JY, Chang YR, Jung W, Kim SW - Korean J Hepatobiliary Pancreat Surg (2014)

Bottom Line: The median survival, 3- and 5-YSR of PR were 23 months, 32.1% and 13.1%, respectively.For NR, they were 9 months, 3.9% and 0%, which were significantly worse than PR (p<0.001).Regional lymph node metastasis (RR, 2.084; 95% CI, 1.491-2.914; p<0.001), non-resections (RR, 2.270; 95% CI, 1.497-3.443; p<0.001), and no chemotherapy (RR, 1.604; 95% CI, 1.095-2.349; p=0.015) were identified as risk factors for poor outcome on multivariate analysis.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.

ABSTRACT

Backgrounds/aims: Little is known about clinical features and survival outcome in locally advanced unresectable extrahepatic cholangiocarcinoma (EHC). The aim was to investigate the clinical features and the survival outcome in these patients, and to evaluate the role of palliative resections in locally advanced unresectable EHC.

Methods: Between 1995 and 2007, 280 patients with locally advanced unresectable EHC were identified. Clinical, pathologic, and survival data were investigated. A comparative analysis was done between those who received palliative resection (PR) and those who were not operated on (NR).

Results: The overall median survival of the study population was 10±1 months, and the 3- and 5-year survival rates (YSR) were 8.5% and 2.5%, respectively. The median survival, 3- and 5-YSR of PR were 23 months, 32.1% and 13.1%, respectively. For NR, they were 9 months, 3.9% and 0%, which were significantly worse than PR (p<0.001). In univariate analysis, T classification, N classification, tumor location, palliative resection, adjuvant treatment, chemotherapy, and radiation therapy were factors that showed survival difference between PR and NR. Regional lymph node metastasis (RR, 2.084; 95% CI, 1.491-2.914; p<0.001), non-resections (RR, 2.270; 95% CI, 1.497-3.443; p<0.001), and no chemotherapy (RR, 1.604; 95% CI, 1.095-2.349; p=0.015) were identified as risk factors for poor outcome on multivariate analysis.

Conclusions: Without evidence of systemic disease, palliative resection may provide some survival benefit in selected locally advanced unresectable EHCs and adjuvant treatment may further improve survival outcome.

No MeSH data available.


Related in: MedlinePlus

Adjuvant treatment shows significantly improved survival in locally advanced unresectable EHCs (A). Subgroup survival analysis demonstrates that palliative resection is essential to improve the benefit of adjuvant treatment (Adj. Tx) (B).
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Figure 4: Adjuvant treatment shows significantly improved survival in locally advanced unresectable EHCs (A). Subgroup survival analysis demonstrates that palliative resection is essential to improve the benefit of adjuvant treatment (Adj. Tx) (B).

Mentions: In terms of adjuvant treatment, 49 patients were confirmed to have received adjuvant treatment. These patients received chemotherapy alone, radiation therapy alone, or concurrent chemoradiation therapy. As shown in Fig. 4A, there was a significant difference in survival outcome between patients who received adjuvant treatment. The median survival of those with adjuvant treatment was 17 months whereas the median survival of those without adjuvant treatment was 9 months (p<0.001). Both chemotherapy and radiation therapy showed significant survival benefits (p<0.001).


Clinical features and survival outcome of locally advanced extrahepatic cholangiocarcinoma.

Lee SJ, Kwon W, Kang MJ, Jang JY, Chang YR, Jung W, Kim SW - Korean J Hepatobiliary Pancreat Surg (2014)

Adjuvant treatment shows significantly improved survival in locally advanced unresectable EHCs (A). Subgroup survival analysis demonstrates that palliative resection is essential to improve the benefit of adjuvant treatment (Adj. Tx) (B).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4492336&req=5

Figure 4: Adjuvant treatment shows significantly improved survival in locally advanced unresectable EHCs (A). Subgroup survival analysis demonstrates that palliative resection is essential to improve the benefit of adjuvant treatment (Adj. Tx) (B).
Mentions: In terms of adjuvant treatment, 49 patients were confirmed to have received adjuvant treatment. These patients received chemotherapy alone, radiation therapy alone, or concurrent chemoradiation therapy. As shown in Fig. 4A, there was a significant difference in survival outcome between patients who received adjuvant treatment. The median survival of those with adjuvant treatment was 17 months whereas the median survival of those without adjuvant treatment was 9 months (p<0.001). Both chemotherapy and radiation therapy showed significant survival benefits (p<0.001).

Bottom Line: The median survival, 3- and 5-YSR of PR were 23 months, 32.1% and 13.1%, respectively.For NR, they were 9 months, 3.9% and 0%, which were significantly worse than PR (p<0.001).Regional lymph node metastasis (RR, 2.084; 95% CI, 1.491-2.914; p<0.001), non-resections (RR, 2.270; 95% CI, 1.497-3.443; p<0.001), and no chemotherapy (RR, 1.604; 95% CI, 1.095-2.349; p=0.015) were identified as risk factors for poor outcome on multivariate analysis.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.

ABSTRACT

Backgrounds/aims: Little is known about clinical features and survival outcome in locally advanced unresectable extrahepatic cholangiocarcinoma (EHC). The aim was to investigate the clinical features and the survival outcome in these patients, and to evaluate the role of palliative resections in locally advanced unresectable EHC.

Methods: Between 1995 and 2007, 280 patients with locally advanced unresectable EHC were identified. Clinical, pathologic, and survival data were investigated. A comparative analysis was done between those who received palliative resection (PR) and those who were not operated on (NR).

Results: The overall median survival of the study population was 10±1 months, and the 3- and 5-year survival rates (YSR) were 8.5% and 2.5%, respectively. The median survival, 3- and 5-YSR of PR were 23 months, 32.1% and 13.1%, respectively. For NR, they were 9 months, 3.9% and 0%, which were significantly worse than PR (p<0.001). In univariate analysis, T classification, N classification, tumor location, palliative resection, adjuvant treatment, chemotherapy, and radiation therapy were factors that showed survival difference between PR and NR. Regional lymph node metastasis (RR, 2.084; 95% CI, 1.491-2.914; p<0.001), non-resections (RR, 2.270; 95% CI, 1.497-3.443; p<0.001), and no chemotherapy (RR, 1.604; 95% CI, 1.095-2.349; p=0.015) were identified as risk factors for poor outcome on multivariate analysis.

Conclusions: Without evidence of systemic disease, palliative resection may provide some survival benefit in selected locally advanced unresectable EHCs and adjuvant treatment may further improve survival outcome.

No MeSH data available.


Related in: MedlinePlus