Abstract
Background: Cholangiocarcinoma is the most common primary malignant tumour of liver in north east of Thailand. Increasing of incidence in Thailand. The incidence of bile duct cancer is low but increasing. Determinants of survival vary in the literature, due to a lack of sufficient numbers of patients in most series.(1)
Objective: To investigate surgical outcome and prognostic factors after curative resection for distal cholangiocarcinoma(CCA) in Srinagarind hospital.
Methods: This study is a cohort study conducted at 9 tertiary care hospitals in northeastern Thailand. They are main public hospitals in the region participated in the Cholangiocarcinoma Screening and Care Program (CASCAP, see details at www.cascap.in.th). These hospitals provided care for most of CCA patients in the region. The CASCAP enrolled all CCA patients clinically diagnosed since February 2014. Patients were diagnosed and treated according to routine, real world clinical practice of participating hospitals. All patients were followed for both providing them clinical or palliative cares and ascertaining for their treatment outcomes. The follow-up was, unless scheduled otherwise, every 3-6 months, depending on the patients’ conditions. The present paper selected all patients enrolled to CASCAP database during February to December 2014. Patients with … were excluded. By this, a total of xxx patients were included in the analysis. The primary outcome was ???. It was defined as ??? This study has been approved by Khon Kaen University Ethic Committee and registered at Thai Clinical Trial Registry (TCTRXXXXXX).
Multivariate analyses were carried out based on the survival data of all patients with histologically confirmed distal CCA who underwent curative resection at Srinagarind hospital from January 2005 to December 2014.
Results: Of xxx patients, most of them, xx.x% were male, with an average age of xx.x±x.x years. At baseline, patients were ???. The rate of was xx.x% and xx.x% at 6 and 12 months, respectively. Report the magnitude of effect of the main finding with 95%CI and p-value such as- The ??? reduced the risk of ??? by xx.x% (RR= 0.x; 95%CI: 0.x to 0.x; P = 0.xxx). Report all magnitude of effects for the secondary objectives as well as other supportive evidences to enhance the findings.
For all XXX patients, R0 resection was carried out on XX (XX%) patients of whom XX (XX%) also had lymph node metastasis. The other patients underwent R1 resection. The overall 1, 3, and 5-year survival rate were XX%, XX%, XX% (95%CI: XX–XX), retrospectively. and median survival time was XX months. Postoperative mortality and morbidity were XX%, and XX% of patients, retrospectively. The XXX ( e.g. : R0 resection and lymph nodes metastases) demonstrated the poor prognostic factors.
Conclusion:R0 resection remains the best chance for long-term survival,
The XXX and XXX were strong prognostic factors after the curative resection for distal CCA.
Keywords: distal cholangiocarcinoma,prognostic factors,R0 resection,R1 resection