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Survival outcomes and progonostic factors of extrahepatic cholangiocarcinoma patients following surgical resection: Adjuvant therapy is a favorable prognostic factor.
[cholangiocarcinoma]
This
study
was
conducted
to
investigate
survival
and
prognostic
factors
for
extrahepatic
cholangiocarcinoma
(
ECC
)
following
surgical
resection
and
evaluate
the
effects
of
postoperative
adjuvant
therapy
(
AT
)
on
overall
survival
(
OS
)
.
We
retrospectively
collected
clinical
and
pathological
data
between
March
,
2008
and
December
,
2013
.
The
Kaplan-
Meier
method
and
the
COX
regression
model
were
used
to
evaluate
the
OS
and
prognostic
factors
of
105
postoperative
ECC
patients
,
of
whom
32
had
received
AT
.
The
patients
were
stratified
into
seven
risk
subgroups
and
the
survival
rates
were
compared
within
each
subgroup
between
patients
who
received
AT
and
those
who
did
not
.
The
results
demonstrated
a
median
OS
of
17
.
6
months
,
with
1
-
and
3
-
year
survival
rates
of
67
.
9
and
19
.
5
%
,
respectively
,
for
the
entire
cohort
.
On
univariate
analysis
,
preoperative
cholangitis
,
non-
R
0
surgical
margins
,
poor
differentiation
grade
,
stage
3
/
4
and
lymphatic
metastasis
were
identified
as
adverse
prognostic
factors
.
AT
was
not
significantly
associated
with
improved
OS
.
However
,
the
subgroup
analysis
revealed
that
the
effect
of
AT
was
significant
only
in
the
lymphatic
metastasis
group
(
median
OS
,
21
.
6
vs
.
10
.
4
months
;
and
3
-
year
OS
,
16
.
6
vs
.
0
%
,
respectively
;
P
=
0
.
02
)
.
The
survival
curves
of
the
AT
and
non-
AT
groups
were
significantly
different
only
for
node-
positive
patients
.
The
COX
regression
model
identified
lymphatic
metastasis
,
surgical
margins
and
AT
as
independent
prognostic
factors
for
ECC
.
A
negative
resection
margin
may
reduce
the
mortality
rate
following
surgery
by
47
%
.
By
contrast
,
lymph
node
metastasis
was
associated
with
a
2
.
18
-
fold
higher
mortality
rate
for
ECC
patients
.
Postoperative
AT
contributed
to
a
0
.
45
-
fold
mortality
rate
compared
to
non-
AT
ECC
patients
.
Therefore
,
we
concluded
that
AT
is
a
favorable
prognostic
factor
for
ECC
patients
and
it
may
prolong
the
survival
of
patients
with
lymphatic
metastasis
.
Our
data
suggest
that
postoperative
AT
should
be
recommended
for
node-
positive
ECC
patients
.
Diseases
Validation
Diseases presenting
"stage 3"
symptom
cholangiocarcinoma
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