Background: Cholangiocarcinoma (CCA) is a secondary most common tumor of hepatobiliary system. The incidence and mortality rate have been increased over the past 3 decades, especially in high parasitic infection endemic area. CCA are usually diagnosed at advance state and have a poor prognosis after curative surgical resection. Pathologic classification is a major prognostic factor for survival rate that helpful for clinician to choosing appropriate treatment and follow-up program for individual patients.
Objective: To study association between pathologic classifications and survival rate.
Methods: A retrospective analysis study in survival rate of patient were diagnosed perihilar cholangiocarcinoma and treated with surgical resection in tertiary hospital from 2011 to 2015. The patients had follow-up history until December 2016. Cox proportional hazards model analysis was performed to identify indexes of prognosis. All indicators were analyzed by univariate and multivariate analysis.
Results: In 2011 to 2015, 300 patients met inclusion criteria were male 70% and female 30%. Mean age of 55.5±5.5 years old (range 30-70). The total follow-up time was 1,000 person-months, and the mortality rate was 50 per 100 person-years. The 1-, 3-, and 5-year survival rates were 50.0%, 25.0% and 12.5%, respectively. The median survival time of conventional adenocarcinoma was 10 months (95% CI 5-15), tubular type 30 months (95% CI 15-30) and papillary type 20 months (95% CI 10-25). On multivariate analysis was found that tubular type was associated with higher survival rate (HR 0.50, 95% CI 0.25-0.75, p-value 0.04)
Conclusions: In parasitic infection endemic area, tubular adenocarcinoma is a good prognostic factor for survival rate in perihilar cholangiocarcinoma. It is difference from western area whereas much lower incidence of parasitic infection.
Key words: Retrospective analysis study, Perihilar cholangiocarcinoma, Pathologic classification, Survival rate.