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Surgery was strongest predictor for survival in cholangiocarcinoma
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Median OS for patients with cholangiocarcinoma who underwent surgery was three times longer than OS for patients who had radiation or chemotherapy.
According to results presented Monday at Digestive Disease Week 2011, median OS was 23 months for patients who underwent surgery compared with 8 months for those who underwent either chemotherapy alone or chemoradiation.
“Surgical intervention provides the longest survival for these patients,” Rebecca Waitrek, MD, said. Waitrek, a surgeon with City of Hope in Duarte, Calif., presented the results. “In unresected patients, chemotherapy has the longest survival, which is equivalent to patients receiving chemoradiation.”
Cholangiocarcinoma develops in the bile ducts and prognosis is poor. Rare in the US, cholangiocarcinoma is more common in Asia and often appears in patients with history of parasitic infection.
Using the Los Angeles County Cancer Surveillance Program, Wiatrek et al examined surgical and medical outcomes for patients treated from 1988 to 2006 and identified 827 patients with cholangiocarcinoma. Most patients had distant disease (27%), 17% local disease and 17% had regional disease.
Sixty percent of the cohort was untreated, 18% had chemotherapy alone, 7% had chemoradiation and 13% had surgery with or without adjuvant treatment.
OS was superior for the surgical arms (HR=0.34; 95% CI, 0.27-0.43) compared with chemotherapy (HR=0.64; 95% CI, 0.55-0.75) or radiation (HR=0.83; 95% CI, 0.67-1.01). Median OS was 3 months for those who were not treated.
Waitrek said that multivariate analysis showed that younger age, limited extent of disease, surgery, and chemotherapy were all factors associated with improved survival. Surgery and chemotherapy were both positive indicators of survival. Radiation therapy was a statistically insignificant independent predictor of survival. – by Jason Harris
Disclosures: Dr. Waitrek reports no relevant financial disclosures.
For more information:
- Waitrek R. #691. Presented at: Digestive Disease Week 2011; May 7-10; Chicago.
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