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Survival and an overview of decision-making in patients with cholangiocarcinoma |
Håvard Mjørud Forsmo, Arild Horn, Asgaut Viste, Dag Hoem and Kjell Øvrebø |
Bergen, Norway
Author Affiliations: Department of Surgery (Forsmo HM, Horn A, Viste A, Hoem D and Øvrebø K), and Department of Surgical Sciences (Viste A), Haukeland University Hospital, Bergen, Norway
Corresponding Author: Håvard Mjørud Forsmo, MD, Department of Surgery, Haukeland University Hospital, 5021 Bergen, Norway (Tel: +47-55975000; Fax: +47-55972842; Email: havard.forsmo@helse-bergen.no) |
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Abstract 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.
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