Survival and quality of life of cholangiocarcinoma patients: a prospective study over a 4 year period

J Gastrointestin Liver Dis. 2010 Sep;19(3):285-90.

Abstract

Background and aims: Cholangiocarcinomas (CCAs) are tumors with a poor prognosis and a lower quality of life (QoL). The aim of this study was to evaluate the survival rate and quality of life in CCA patients.

Method: We prospectively enrolled 133 patients diagnosed with CCA in the 3rd Medical Clinic, Cluj Napoca, over a 4-year period (2005-2009). The QoL was evaluated by means of a QoL questionnaire (EORTC QLQ-C30).

Results: The mean age of the patients was 65 +/- 10.6 years: 55% were males. 71% of the patients had hilar tumor (Klatskin), 23% distal and 6% intrahepatic CCA (IH). Only 11.3% of the patients were eligible to receive curative treatment. The 1-year overall survival was 22.3 +/- 4.4% and the 2-year survival was 3.4 +/- 2.1%. The patients receiving metallic stents had better survival than those receiving plastic stents (40.4% vs 12.5% at 1 year, 9.1% vs 5.0% at 2 years, respectively). The 1-year survival was significantly improved for patients who underwent surgery plus adjuvant chemotherapy. The post-therapy QoL demonstrated a less improvement in Klatskin tumor patients than in patients with other types of tumors. Endoscopic palliative therapy allowed a faster community reintegration, but with variable evolution.

Conclusions: The highest 2-year survival rate was 5.5%. Slightly longer survival was recorded when chemotherapy was added and also after endoscopic placement of metallic stents. Endoscopic biliary decompression improved the QoL faster than surgery.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Bile Duct Neoplasms / mortality*
  • Bile Duct Neoplasms / pathology
  • Bile Duct Neoplasms / psychology
  • Bile Duct Neoplasms / therapy
  • Bile Ducts, Intrahepatic* / pathology
  • Biliary Tract Surgical Procedures
  • Chemotherapy, Adjuvant
  • Cholangiocarcinoma / mortality*
  • Cholangiocarcinoma / pathology
  • Cholangiocarcinoma / psychology
  • Cholangiocarcinoma / therapy
  • Decompression, Surgical
  • Endoscopy
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Logistic Models
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Odds Ratio
  • Palliative Care
  • Prospective Studies
  • Quality of Life*
  • Risk Assessment
  • Risk Factors
  • Romania / epidemiology
  • Stents
  • Surveys and Questionnaires
  • Survival Rate
  • Time Factors
  • Treatment Outcome