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World J Gastroenterol. May 28, 2008; 14(20): 3224-3230
Published online May 28, 2008. doi: 10.3748/wjg.14.3224
Prognostic factors in patients with advanced cholangiocarcinoma: Role of surgery, chemotherapy and body mass index
Mirna H Farhat, Ali I Shamseddine, Ayman N Tawil, Ghina Berjawi, Charif Sidani, Wael Shamseddeen, Kassem A Barada
Mirna H Farhat, Ali I Shamseddine, Division of Hematology- Oncology, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, 110 72020, Lebanon
Ayman N Tawil, Department of Pathology, American University of Beirut Medical Center, Beirut, 110 72020, Lebanon
Ghina Berjawi, Charif Sidani, Department of Radiology, American University of Beirut Medical Center, Beirut, 110 72020, Lebanon
Wael Shamseddeen, Department of Public health, American University of Beirut Medical Center, Beirut, 110 72020, Lebanon
Kassem A Barada, Division of Gastroenterology, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, 110 72020, Lebanon
Author contributions: Farhat MH, Shamseddine AI, Barada KA designed research; Tawil AN reviewed pathology; Berjawi G and Sidani C reviewed radiology; Shamsedeen W analyzed data; Farhat MH wrote the paper; Shamseddine AI and Barada KA reviewed the paper.
Correspondence to: Kassem Barada, MD, Division of Gastroenterology, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, 110 72020, Lebanon. kb02@aub.edu.lb
Telephone: +961-3-780909
Fax: +961-3-50005112
Received: January 22, 2008
Revised: March 11, 2008
Accepted: March 18, 2008
Published online: May 28, 2008
Abstract

AIM: To study the factors that may affect survival of cholangiocarcinoma in Lebanon.

METHODS: A retrospective review of the medical records of 55 patients diagnosed with cholangio-carcinoma at the American University of Beirut between 1990 and 2005 was conducted. Univariate and multivariate analyses were performed to determine the impact of surgery, chemotherapy, body mass index, bilirubin level and other factors on survival.

RESULTS: The median survival of all patients was 8.57 mo (0.03-105.2). Univariate analysis showed that low bilirubin level (< 10 mg/dL), radical surgery and chemotherapy administration were significantly associated with better survival (P = 0.012, 0.038 and 0.038, respectively). In subgroup analysis on patients who had no surgery, chemotherapy administration prolonged median survival significantly (17.0 mo vs 3.5 mo, P = 0.001). Multivariate analysis identified only low bilirubin level < 10 mg/dL and chemotherapy administration as independent predictors associated with better survival (P < 0.05).

CONCLUSION: Our data show that palliative and postoperative chemotherapy as well as a bilirubin level < 10 mg/dL are independent predictors of a significant increase in survival in patients with cholangiocarcinoma.

Keywords: Cholangiocarcinoma; Biliary tract cancer; Chemotherapy; Bilirubin; Prognosis