Abstract
Intrahepatic cholangiocarcinoma (ICC), one of the primary liver cancers, is frequent in the northeastern part of Thailand. Surgical resection remains the best method of treatment, but patients suffering from ICC usually present at a late stage of the disease. Studies of survival and prognostic factors after surgery remain rare. The aim here was to evaluate the survival rate and factors affecting the survival of patients with intrahepatic cholangiocarcinoma after surgery. The study used a retrospective cohort design. The subjects were 73 consecutive patients with ICC, who were admitted for surgery to Srinagarind Hospital, Khon Kaen University, during the period 2005-2009. The censoring date was 31 December, 2011, data being evaluated using uni- and multivariate analyses. Postoperative survival analysis was 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 99 person-years. The total number of deaths was 59, giving a mortality rate of 59 per 100 person-years. The cumulative 1-, 3-, and 5-year survival rates were 52.1%, 21.7%, and 11.2%, respectively. The median duration of survival after resection was 12.4 months. Univariate analysis revealed stage of disease, lymph node metastasis, histological type, histological grade and macroscopic classification to be statistically significant (p-value<0.05) prognostic factors. In the multivariate analysis, only macroscopic classification was statistically significant (p-value<0.05). In conclusion, macroscopic classification was the only independent factor found to be significantly associated with survival following surgical treatment of ICC.
Highlights
Cancer is a major health problem around the world; in 2010, there were 789,620 new cancer cases in males and 739,940 new cancer cases in females
Surgical resection remains the best method of treatment, but patients suffering from Intrahepatic cholangiocarcinoma (ICC) usually present at a late stage of the disease
The high incidence of CCA in northeast Thailand is linked to high levels of infection by the liver fluke, Opisthorchis viverrini, and programmes for the control of infection by this parasite have played a role in the primary prevention of the disease for decades (Saengsawang et al, 2012)
Summary
Cancer is a major health problem around the world; in 2010, there were 789,620 new cancer cases in males and 739,940 new cancer cases in females. Cholangiocarcinoma (CCA), including both the intrahepatic and extrahepatic bile duct forms of the disease, is the most common cancer in Thailand, especially in the northeastern region where the incidence rate has been the highest in the world. In the northeast province of Khon Kaen, where 89% of liver cancers are CCA (Vatanasapt et al, 1995), the age-adjusted incidence rates for liver cancer have been 89.2 and 35.5 per 100,000 in males and in females, respectively (Vatanasapt et al, 1990). The high incidence of CCA in northeast Thailand is linked to high levels of infection by the liver fluke, Opisthorchis viverrini, and programmes for the control of infection by this parasite have played a role in the primary prevention of the disease for decades (Saengsawang et al, 2012). Due to the large number of patients presenting with the disease, tertiary prevention is important
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