Poor Prognosis of Advanced Cholangiocarcinoma: Real-World Data from a Tertiary Referral Center.
Aged
Aged, 80 and over
Antineoplastic Combined Chemotherapy Protocols
/ therapeutic use
Bile Duct Neoplasms
/ mortality
Chemoembolization, Therapeutic
/ mortality
Cholangiocarcinoma
/ mortality
Combined Modality Therapy
Female
Humans
Male
Palliative Care
/ methods
Prognosis
Retrospective Studies
Tertiary Care Centers
/ statistics & numerical data
Treatment Outcome
Biliary tract cancer
Chemotherapy
Multimodal treatment
Journal
Digestion
ISSN: 1421-9867
Titre abrégé: Digestion
Pays: Switzerland
ID NLM: 0150472
Informations de publication
Date de publication:
2020
2020
Historique:
received:
20
12
2018
accepted:
12
05
2019
pubmed:
28
5
2019
medline:
17
4
2021
entrez:
27
5
2019
Statut:
ppublish
Résumé
Incidence of cholangiocarcinoma (CCA) in western countries is rising. In the palliative setting, chemotherapy is the only established treatment. The evidence for other treatments including locoregional therapy is low. However, such individual treatments are offered in a real-world setting. The aim of this study is to document the offered treatments and to analyze the survival of patients with unresectable CCA treated at a tertiary referral center. Data from 220 consecutive patients with CCA treated at a German university cancer center from January 1, 2008, until December 31, 2012. Of those, 105 patients were unresectable. Survival curves were calculated according to the Kaplan-Meier method; log-rank test was applied for survival analysis. Any palliative treatment was beneficial for patients with unresectable CCA when compared to best supportive care (BSC) alone; median OS with BSC was 10 weeks (BSC vs. transarterial chemoembolization [TACE] p = 0.017, HR 0.36; BSC vs. TACE/chemotherapy p < 0.001, HR 0.24; BSC vs. chemotherapy p < 0.001, HR 0.31). Combination of TACE and chemotherapy prolonged overall survival as compared to TACE alone (105 vs. 43 weeks, p = 0.045). Prognosis in advanced stage CCA is still very poor. However, multimodal treatment in palliative patients significantly prolong survival.
Sections du résumé
BACKGROUND
BACKGROUND
Incidence of cholangiocarcinoma (CCA) in western countries is rising. In the palliative setting, chemotherapy is the only established treatment. The evidence for other treatments including locoregional therapy is low. However, such individual treatments are offered in a real-world setting. The aim of this study is to document the offered treatments and to analyze the survival of patients with unresectable CCA treated at a tertiary referral center.
PATIENTS AND METHODS
METHODS
Data from 220 consecutive patients with CCA treated at a German university cancer center from January 1, 2008, until December 31, 2012. Of those, 105 patients were unresectable. Survival curves were calculated according to the Kaplan-Meier method; log-rank test was applied for survival analysis.
RESULTS
RESULTS
Any palliative treatment was beneficial for patients with unresectable CCA when compared to best supportive care (BSC) alone; median OS with BSC was 10 weeks (BSC vs. transarterial chemoembolization [TACE] p = 0.017, HR 0.36; BSC vs. TACE/chemotherapy p < 0.001, HR 0.24; BSC vs. chemotherapy p < 0.001, HR 0.31). Combination of TACE and chemotherapy prolonged overall survival as compared to TACE alone (105 vs. 43 weeks, p = 0.045).
CONCLUSION
CONCLUSIONS
Prognosis in advanced stage CCA is still very poor. However, multimodal treatment in palliative patients significantly prolong survival.
Identifiants
pubmed: 31129660
pii: 000500894
doi: 10.1159/000500894
doi:
Types de publication
Evaluation Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
458-465Informations de copyright
© 2019 S. Karger AG, Basel.