Survival Rates of Cholangiocarcinoma and Factors Affecting after Surgical Treatment in Roi Et Hospital - อัตราการรอดชีพของผู้ป่วยมะเร็งท่อน้ำดี และปัจจัยทีมีผลหลังการผ่าตัดในโรงพยาบาลร้อยเอ็ด

บทคัดย่อ

                  Cholangiocarcinoma (CHCA) is the most common cancer in Thailand, especially in the northeast region. Most cholangiocarcinoma patients consulted a doctor at a late stage. Surgery is still the best treatment. The objective of this study was to evaluate survival rates and factors affecting survival in cholangiocarcinoma patients following surgery at Roi Et Hospital, Thailand. A retrospective cohort study was conducted in 91 patients who were diagnosed and treated by surgical resection at Roi Et Hospital between 1 January 2010 and 31 December 2012. The patients were followed up until death or the end of the study (31 December, 2013). Survival rates were calculated by using the Kaplan-Meier method; and the Cox proportional hazard model was used to identify independent prognostic factors. It was found that the total follow-up time was 1,127 person-months; and the mortality rate was 62 per 100 person-years for intrahepatic CHCA and was 43 per 100 person-years for extrahepatic CHCA. The cumulative 1- and 3-year survival rates were 46.75% and 13.48% for intrahepatic CHCA and The cumulative 1- and 2-year survival rates were 57.14 and 21.43 for extrahepatic CHCA, respectively. The median survival time after resection was 11 months for intrahepatic CHCA and was 16 months for extrahepatic CHCA. After adjusting for age, gender, lymph node metastasis and histological type, resection margin and lymph nodes remained as a statistically significant prognostic factor for survival following surgery. A positive resection margin was associated with a 2.46 folds higher mortality rate than a negative margin and lymph node metastasis was associated with a 2.98 folds higher mortality rate than that not metastasis. Thus resection margins and lymph node metastasis were important prognostic factors affecting survival of cholangiocarcinoma patients after surgery both intra and extrahepatic CHCA. A negative resection margin could reduce the mortality rate by 59.00% and negative lymph node metastasis could reduce the mortality rate by 66.00%

Key words: cholangiocarcinoma, intrahepatic, extrahepatic, surgical treatment, survival rate