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

Abstract

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.

Prognostic Value of Positron Emission Tomography in Advanced Cholangiocarcinoma: A Single-Institution Study and Literature Review

“…Age is an unsurprising factor given the constitutional changes of aging and general trends of morbidity and mortality. Previous studies have also shown serum albumin level, which may indicate nutritional status, and serum CA 19-9, which may indicate tumor burden, to be prognostic for cholangiocarcinoma [ 21 - 23 ]. CA 19-9 was predictive of survival after resection of extrahepatic cholangiocarcinoma, ranging in cut-off value from 30 to 300 U/mL.…”

Phase II Trial of FOLFIRINOX in Advanced Biliary Tract Cancer

“…The landmark ABC-02 trial demonstrated a survival benefit with GemCis compared to gemcitabine alone, making it the standard first-line treatment [ 5 ]. However, despite this advancement, the prognosis for metastatic BTC remains dismal, with a median survival of less than a year [ 5 , 6 ]. This underscores the urgent need for more effective therapies for this challenging disease.…”