BACKGROUND:Cholangiocarcinoma is rare,accounting for approximately 3%of all gastrointestinal cancers.This study aimed to identify the survival rate among surgically treated and palliated patients,and secondly to ident...BACKGROUND:Cholangiocarcinoma is rare,accounting for approximately 3%of all gastrointestinal cancers.This study aimed to identify the survival rate among surgically treated and palliated patients,and secondly to identify parameters that could predict a curative resection. METHODS:A total of 121 patients,55 men and 66 women, median age 70 years(range 31-91),who had been treated for cholangiocarcinoma in the period of 1990-2005 were evaluated retrospectively. RESULTS:Curative resection was performed in 40 patients (33%),whereas 81 received palliative treatment(67%).16% (19 of 121)of the patients had an explorative laparotomy without tumour resection.Age above 65 years(OR 3.4;95% CI 1.4-8.4;P=0.008),weight loss(OR 8.5;95%CI 1.5-46; P=0.01)or tumour location(The resection rate of hilar cholangiocarcinoma was lower than that of intrapancreatic cancer.)(OR 2.7;95%CI 1.7-4.5;P=0.001)predicted palliative treatment.The adjusted 5-year survival rate of patients who received tumour resection and palliative treatment was 30%and 1.2%,respectively(P<0.001).The survival rate of patients who were subjected to hepatectomy (70%)was better than that of patients who had a local or distal resection(20%)(P=0.02). CONCLUSIONS:In few patients with a resectable cholangiocarcinoma,an explorative laparotomy is often necessary to evaluate resectability.However,long-term survival is significantly better in patients who received radical surgical resection.展开更多
文摘BACKGROUND:Cholangiocarcinoma is rare,accounting for approximately 3%of all gastrointestinal cancers.This study aimed to identify the survival rate among surgically treated and palliated patients,and secondly to identify parameters that could predict a curative resection. METHODS:A total of 121 patients,55 men and 66 women, median age 70 years(range 31-91),who had been treated for cholangiocarcinoma in the period of 1990-2005 were evaluated retrospectively. RESULTS:Curative resection was performed in 40 patients (33%),whereas 81 received palliative treatment(67%).16% (19 of 121)of the patients had an explorative laparotomy without tumour resection.Age above 65 years(OR 3.4;95% CI 1.4-8.4;P=0.008),weight loss(OR 8.5;95%CI 1.5-46; P=0.01)or tumour location(The resection rate of hilar cholangiocarcinoma was lower than that of intrapancreatic cancer.)(OR 2.7;95%CI 1.7-4.5;P=0.001)predicted palliative treatment.The adjusted 5-year survival rate of patients who received tumour resection and palliative treatment was 30%and 1.2%,respectively(P<0.001).The survival rate of patients who were subjected to hepatectomy (70%)was better than that of patients who had a local or distal resection(20%)(P=0.02). CONCLUSIONS:In few patients with a resectable cholangiocarcinoma,an explorative laparotomy is often necessary to evaluate resectability.However,long-term survival is significantly better in patients who received radical surgical resection.
