Survival Rate of Extrahepatic Cholangiocarcinoma Patients after Surgical Treatment in Thailand

Background: Intra- and extrahepatic cholangiocarcinoma (CCA) is the most common cancer in Thailand,especially in the northeast region. Most extrahepatic CCA patients consult a doctor at a late stage. Surgery isstill the best treatment.
Objectives: The aim of this study was to evaluate survival rates and factors affectingsurvival in extrahepatic CCA patients following surgery at Srinagarind Hospital, Khon Kaen University, Thailand.Materials and
Methods: A retrospective cohort study was conducted with 58 patients who were diagnosed andtreated by surgical resection by the same surgeon at Srinagarind Hospital between 2005 and 2009. The patientswere followed up until death or the end of the study (31 December, 2011). Survival rates were calculated by theKaplan-Meier method, and the Cox proportional hazard model was used to identify independent prognosticfactors.
Results: The total follow-up time was 1,215 person-months, and the mortality rate was 50 per 100person-years. The cumulative 1-, 3-, and 5-year survival rates were 62.1%, 21.7% and 10.8%, respectively. Themedian survival time after resection was 15 months. After adjusting for age, gender, lymph node metastasis andhistological type, resection margin remained as a statistically significant prognostic factor for survival followingsurgery. A positive resection margin was associated with a 2.3-fold higher mortality rate than a negative margin.
Conclusions: Resection margins are important prognostic factors affecting survival of extrahepatic CCA patientsafter surgery. A negative resection margin can reduce the mortality rate by 56%.