摘要
Background:Cholangiocarcinoma was considered as a dismal disease with very poor prognosis until re-cently.Cholangiocarcinoma is increasingly found due to increased life expectancy.Although surgical and medical management were advanced recently,data on the prognosis,especially extrahepatic cholangio-carcinoma(ECC),were limited.This study aimed to identify clinicopathologic features and prognosis of patients with ECC.Methods:Patients followed up and diagnosed with ECC between January 2014 and December 2016 at a tertiary hospital were included,whereas those with intrahepatic cholangiocarcinoma,gallbladder cancer,and ampullary cancer were excluded.Results:A total of 83 patients were followed after the treatment(49 men and 34 women;median age 73.3 years).Cancer location was classified as distal common bile duct(25 patients),proximal com-mon bile duct(24 patients),common hepatic duct(20 patients),and hilar(14 patients).About 14.5%of patients had history of another malignant neoplasm,and 24.1%patients had chronic illness.Surgi-cal resection was performed in 54 patients(65%)and dysplasia was combined in 63%(34/54).Adjuvant chemotherapy was performed in 54%(29/54),but only 7 underwent palliative chemotherapy in 29 non-surgical patients.The median overall survival in all patients was 30.9 months.In analyzing the treatment modality,median survival of adjuvant chemotherapy,surgery only,palliative chemotherapy,and support-ive care groups were 42.9,30.9,12.0,and 8.9 months,respectively(P<0.05).In the Cox regression analy-sis of survival,age,surgical resection,chemotherapy,and comorbidity were significant prognostic factors,and the comorbidity was the only significant prognostic factor in the multivariable analysis(hazard ratio[HR]=2.80;95%CI:1.32–5.95;P=0.007).In a subgroup analysis of surgical patients,the presence of dysplasia was a favorable prognostic factor in the multivariable analysis(HR=0.29;95%CI:0.09–0.91;P=0.033).Conclusions:The overall survival of patients with ECC was quite high and increased with chemotherapy.Absence of comorbidity,and presence of dysplasia were good prognostic factors.
