Download PDF
CC BY-NC-ND 4.0 · South Asian J Cancer 2022; 11(01): 036-039
DOI: 10.1055/s-0041-1730889
Original Article
Gastrointestinal Cancer

Treatment Outcomes of Advanced Cholangiocarcinoma: A Single-Center Experience from India

Niranjan Vijayaraghavan
1   Department of Medical Oncology, Madras Medical College, Chennai, Tamil Nadu, India
,
Rakesh MP
1   Department of Medical Oncology, Madras Medical College, Chennai, Tamil Nadu, India
,
Latha KVS
1   Department of Medical Oncology, Madras Medical College, Chennai, Tamil Nadu, India
› Author Affiliations Funding We did not receive any grant or funding for our study.
› Further Information
   Permissions and Reprints

Abstract

Zoom Image
Niranjan Vijayaraghavan

Background Survival data for patients with advanced cholangiocarcinoma are very sparse in India. We performed this study to find the median overall survival of patients with advanced cholangiocarcinoma and to identify prognostic factors for survival.

Methods This is a retrospective study of 30 patients with inoperable and metastatic cholangiocarcinoma treated with cisplatin and gemcitabine chemotherapy. Overall survival was estimated by the Kaplan–Meier method. Univariate and multivariate analyses were performed to determine the impact of age, gender, performance status, carbohydrate antigen (CA) 19.9, liver function test on survival. Data were analyzed using SPSS version 21.

Results The mean age of the population was 47.5 years (±14.5). The most common presenting complaint was jaundice followed by abdominal pain. Extrahepatic cholangiocarcinoma comprised of 86%. Median number of cycles was 4 and the response rate was 46.6% (partial response and stable disease) The median overall survival was 9 months (95% confidence interval = 6.0–11.8 months). The median survival of patients with Eastern Cooperative Oncology Group performance score < 2 and ≥2 were 15.6 and 4.2 months (p = 0.002), respectively. The median overall survival for patients with albumin > 3.0 g/dL was 12.1 and 4.5 months for < 3.0 g/dL (p = 0.039). Patients with CA 19.9 < 200 U/mL had a better overall survival (13.2 months) than those above 200 U/mL (5.6 months) (p = 0.001). In the multivariate analysis, performance status was found to be the only independent prognostic factor.

Conclusion Advanced cholangiocarcinoma has a poor prognosis. Performance status, serum albumin, and CA 19.9 were found to be prognostic.

Keywords

cholangiocarcinoma - chemotherapy - survival


Publication History

Article published online:
17 May 2022

© 2022. MedIntel Services Pvt Ltd. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 Pracht M, Le Roux G, Sulpice L. et al. Chemotherapy for inoperable advanced or metastatic cholangiocarcinoma: retrospective analysis of 78 cases in a single center over four years. Chemotherapy 2012; 58 (02) 134-141
    CrossrefPubMedGoogle Scholar
  • 2 Babu VPK, Talwar V, Raina S. et al. Gemcitabine with carboplatin for advanced intrahepatic cholangiocarcinoma: a study from North India Cancer Centre. Indian J Cancer 2018; 55 (03) 222-225
    CrossrefPubMedGoogle Scholar
  • 3 Valle J, Wasan H, Palmer DH. et al; ABC-02 Trial Investigators. Cisplatin plus gemcitabine versus gemcitabine for biliary tract cancer. N Engl J Med 2010; 362 (14) 1273-1281
    CrossrefPubMedGoogle Scholar
  • 4 Borie F, Niampa H, Bouvier AM. et al. [Current management and prognosis of intrahepatic cholangiocarcinoma in France]. Gastroenterol Clin Biol 2009; 33 (10-11): 971-976
    PubMedGoogle Scholar
  • 5 Verslype C, Prenen H, Van Cutsem E. The role of chemotherapy in biliary tract carcinoma. HPB (Oxford) 2008; 10 (03) 164-167
    CrossrefPubMedGoogle Scholar
  • 6 Wiazzane N, Chauffert B, Ghiringhelli F. Retrospective analysis of survival benefits of chemotherapy for metastatic or non-resectable intrahepatic cholangiocarcinoma. Clin Res Hepatol Gastroenterol 2013; 37 (06) 614-618
    CrossrefPubMedGoogle Scholar
  • 7 Waghray A, Sobotka A, Marrero CR, Estfan B, Aucejo F, Narayanan Menon KV. Serum albumin predicts survival in patients with hilar cholangiocarcinoma. Gastroenterol Rep (Oxf) 2017; 5 (01) 62-66
    PubMedGoogle Scholar
  • 8 Harder J, Kummer O, Olschewski M, Otto F, Blum HE, Opitz O. Prognostic relevance of carbohydrate antigen 19-9 levels in patients with advanced biliary tract cancer. Cancer Epidemiol Biomarkers Prev 2007; 16 (10) 2097-2100
    CrossrefPubMedGoogle Scholar
  • 9 Charoentum C, Thongprasert S, Chewaskulyong B, Munprakan S. Experience with gemcitabine and cisplatin in the therapy of inoperable and metastatic cholangiocarcinoma. World J Gastroenterol 2007; 13 (20) 2852-2854
    CrossrefPubMedGoogle Scholar
  • 10 Carraro S, Servienti PJ, Bruno MF. et al. Gemcitabine and cisplatin in locally advanced or metastatic gallbladder and bile duct adenocarcinomas. Proc Am Soc Clin Oncol 2001; 20: 146b (Abst)
    Google Scholar
  • 11 Okusaka T, Nakachi K, Fukutomi A. et al. Gemcitabine alone or in combination with cisplatin in patients with biliary tract cancer: a comparative multicentre study in Japan. Br J Cancer 2010; 103 (04) 469-474
    CrossrefPubMedGoogle Scholar
  • 12 Kang MJ, Jang JY, Chang J. et al. Actual long-term survival outcome of 403 consecutive patients with hilar cholangiocarcinoma. World J Surg 2016; 40 (10) 2451-2459
    CrossrefPubMedGoogle Scholar
  • 13 Farley DR, Weaver AL, Nagorney DM. “Natural history” of unresected cholangiocarcinoma: patient outcome after noncurative intervention. Mayo Clin Proc 1995; 70 (05) 425-429
    CrossrefPubMedGoogle Scholar