Conditional survival in patients with unresectable perihilar cholangiocarcinoma. Issue 11 (November 2017)

• Record Type: Journal Article
• Authors: Gaspersz, Marcia P.; Buettner, Stefan; van Vugt, Jeroen L.A.; Roos, Eva; Coelen, Robert J.S.; Vugts, Jaynee; Belt, Eric J.; de Jonge, Jeroen; Polak, Wojciech G.; Willemssen, François E.J.A.; van Gulik, Thomas M.; IJzermans, Jan N.M.; Groot Koerkamp, Bas
• Is Part Of: HPB. Volume 19:Issue 11(2017)
• Page Start: 966
• Page End: 971
• Publication Date: 2017-11
• Subjects: Liver -- Diseases -- Periodicals; Biliary tract -- Diseases -- Periodicals; Pancreas -- Diseases -- Periodicals; 616.362005
• DOI: 10.1016/j.hpb.2017.07.004
• Languages: English
• ISSNs: 1365-182X

Abstract

Abstract: Background: Conditional survival is the life expectancy from a point in time for a patient who has survived a specific period after presentation. The aim of the study was to estimate conditional survival for patients with unresectable perihilar cholangiocarcinoma. Methods: Patients with unresectable perihilar cholangiocarcinoma from two academic hospitals in the Netherlands between 2002 and 2012 were assessed. A multivariable Cox proportional hazards analysis was performed to identify risk factors associated with overall survival. Survival was estimated using the Kaplan–Meier method to evaluate factors associated with overall survival. Results: In total, 572 patients were included. Overall survival was 42% at one year and 6% at three years. The conditional chance of surviving three years was 15% at 1 year and increased to 38% at 2 years. Independent poor prognostic factors for overall survival were age ≥65 years, tumor size >3 cm on imaging, bilirubin levels (>250 μmol/L), CA19-9 level at presentation (>1000 U/ml), and suspected distant metastases on imaging. The conditional survival of patients with and without these prognostic factors was comparable after patients survived the first two or more years. Conclusion: The conditional chance of surviving for patients with unresectable perihilar cholangiocarcinoma increases with time. Poor prognostic factors become less relevant once patients have survived two years.