Korean J Gastroenterol.  2009 Oct;54(4):227-234. 10.4166/kjg.2009.54.4.227.

Clinical Characteristics of Intrahepatic Cholangiocarcinoma and Prognostic Factors in Patients Who Received Non-surgical Treatment

Affiliations
  • 1Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea. jbi@med.yu.ac.kr

Abstract

BACKGROUND/AIMS
This study was conducted to analyze the prognostic factors in patients with intrahepatic cholangiocarcinoma (ICC) who did not receive surgery.
METHODS
Between August 1997 and November 2007, the medical records of 175 patients (mean age; 66 years, male/female 126/49), who were diagnosed as ICC, were reviewed retrospectively.
RESULTS
Clonorchiasis and hepatolithiasis was found in 14.9%, and 6.3% of all patients, and no risk factors were identified in 77.8% of them. Surgical resection was performed in 29.1% (51 patients), chemotherapy +/- radiotherapy in 12.6% (22 patients), and palliative therapy in 58.3% (102 patients). The proportion of patients with stage I was 23.4% (41 patients). The prognostic factors in patients who did not receive surgery were alkaline phosphatase (ALP) and bilirubin levels by univariate and multivariate analysis. The median survival of patients with normal ALP and bilirubin levels was six months, whereas only one month in patients with elevated ALP and bilirubin levels (p<0.001). Tumor characteristics of patients with elevated bilirubin and ALP levels were infiltrative tumor, bile duct involvement, and very huge tumor.
CONCLUSIONS
The prognostic factors of ICC in patients who did not receive surgery were ALP and bilirubin levels, but not lymph node metastasis.

Keyword

Intrahepatic cholangiocarcinoma; Prognostic factor; Survival; Bilirubin; Alkaline phosphatase

MeSH Terms

Adult
Aged
Aged, 80 and over
Alkaline Phosphatase/analysis
Bile Duct Neoplasms/*diagnosis/mortality
*Bile Ducts, Intrahepatic
Bilirubin/analysis
Cholangiocarcinoma/*diagnosis/mortality
Female
Humans
Lymphatic Metastasis
Male
Middle Aged
Prognosis
Retrospective Studies
Risk Factors
Survival Rate

Figure

  • Fig. 1. Comparison of survival rate according to clinical variables; lymph node metastasis (A), tumor size (B), stages (C), bilirubin level (D), ALP level (E), and bilirubin plus ALP levels (F).


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