Analysis of treatment methods and prognostic factors in 354 cases of hilar cholangiocarcinoma: A cohort study

J Cancer Res Ther. 2020;16(2):230-237. doi: 10.4103/jcrt.JCRT_637_19.

Abstract

Context: Better management strategies are needed to improve the survival of patients with hilar cholangiocarcinoma (HCCA).

Aims: This study was designed to examine the effects of different treatment methods on survival and prognostic factors in HCCA.

Settings and design: We retrospectively analyzed the clinical data of 354 patients with HCCA treated at our institution from 2003 to 2013.

Materials and methods: Patients were divided into three groups according to the treatment: the radical resection group, the nonradical resection group, and the biliary drainage-only group.

Statistical analysis used: The Kaplan-Meier method was used to compare survival rates between the groups, and the independent prognostic factors were assessed using the Cox proportional hazards model.

Results: There were 110 patients in the radical resection group, 93 patients in the nonradical resection group, and 151 patients in the biliary drainage-only group, and they showed differing survival rates: 1-year survival rates of 70.7%, 49.5%, and 31.3%; 2-year survival rates of 62.9%, 24.7%, and 9.0%; 3-year survival rates of 34.7%, 4.0%, and 0%; and median survival of 21.7 months, 13.6 months, and 8.7 months, respectively. The radical resection group had the longest overall survival (P< 0.001). Treatment method, albumin (ALB), total bilirubin (TBIL), postoperative pathological T-stage, and distant metastasis were identified as independent prognostic indicators of survival.

Conclusions: Radical resection significantly increases survival in patients with HCCA, and an increase in ALB and a decrease in TBIL improve the prognosis of patients with HCCA.

Keywords: Curative effects; hilar cholangiocarcinoma; influence factor; prognostic.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Bile Duct Neoplasms / blood
  • Bile Duct Neoplasms / mortality
  • Bile Duct Neoplasms / pathology*
  • Bile Duct Neoplasms / therapy
  • Biliary Tract Surgical Procedures / mortality*
  • Bilirubin / blood*
  • Biomarkers, Tumor / blood*
  • Biomarkers, Tumor / metabolism
  • Drainage / mortality*
  • Female
  • Follow-Up Studies
  • Humans
  • Klatskin Tumor / blood
  • Klatskin Tumor / mortality
  • Klatskin Tumor / pathology*
  • Klatskin Tumor / therapy
  • Male
  • Middle Aged
  • Retrospective Studies
  • Risk Factors
  • Serum Albumin, Human / metabolism*
  • Survival Rate
  • Treatment Outcome

Substances

  • Biomarkers, Tumor
  • Bilirubin
  • Serum Albumin, Human