Brief Article
Copyright ©2012 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Feb 7, 2012; 18(5): 458-465
Published online Feb 7, 2012. doi: 10.3748/wjg.v18.i5.458
Survival analysis of cholangiocarcinoma: A 10-year experience in Malaysia
Ahmad Ramzi Yusoff, Mohd Muzammil Abdul Razak, Boon Koon Yoong, R Vijeyasingam, Zuraidah Mahmud Siti
Ahmad Ramzi Yusoff, Faculty of Medicine, Universiti Tekno-logi MARA, Sg. Buloh Campus, 47000 Sg. Buloh, Selangor, Malaysia
Mohd Muzammil Abdul Razak, R Vijeyasingam, Yoong Boon Koon, Department of Surgery, University Malaya Medical Centre, 59100 Kuala Lumpur, Malaysia
Siti Zuraidah Mahmud, Institute for Medical Research, Jalan Pahang, 50588 Kuala Lumpur, Malaysia
Author contributions: Yusoff AR designed the study, collected and analyzed data, and drafted the manuscript; Abdul Razak MM and Yoong BK supervised the research; Vijeyasingam R operated on patients and provided the data; and Siti ZM edited the article and conducted the literature review.
Correspondence to: Dr. Ahmad Ramzi Yusoff, Faculty of Medicine, Universiti Teknologi MARA, Sg. Buloh Campus, 47000 Sg. Buloh, Selangor, Malaysia. dr_aramzy@yahoo.com
Telephone: +60-3-61564182 Fax: +60-3-61564292
Received: February 2, 2011
Revised: April 26, 2011
Accepted: May 3, 2011
Published online: February 7, 2012
Abstract

AIM: To investigate the clinical features and survival of patients treated for cholangiocarcinoma in our institution and to analyze the factors affecting their survival.

METHODS: This retrospective cohort study assessed patients diagnosed with cholangiocarcinoma between January 1997 and December 2007 at the University Malaya Medical Centre in Malaysia. The clinical data and associated outcomes were collected using a structured proforma.

RESULTS: Of the 69 patients diagnosed with cholangiocarcinoma, 38 (55%) were male; mean patient age was 61 years. Twelve patients (17%) had intrahepatic, 38 (55%) had perihilar and 19 (28%) had distal tumors. Only 12 patients underwent curative surgery, including seven R0 resections. Only one patient died within 30 d after surgery. The overall median survival was 4 mo, whereas the median survival of R0 resected patients was 16 mo. The overall 1-, 2- and 3-year cumulative survival rates were 67%, 17% and 17%, respectively. Survival rates were significantly associated with curative resection (P = 0.002), intrahepatic tumor (P = 0.003), negative margin status (P = 0.013), early tumor stage (P = 0.016), higher tumor differentiation (P = 0.032) and absence of jaundice (P = 0.038). Multivariate analysis showed that tumor location was a significant independent predictor of patient survival.

CONCLUSION: Curative, margin-negative resection of early stage, well-differentiated intrahepatic tumors is associated with improved patient survival.

Keywords: Cholangiocarcinoma; Bile duct tumor; Surgery; Malaysia