Catalin Vlad1,2, Andrei Havasi2,11*, Patriciu Achimas1,2*, Calin Cainap1,2, Laura Pop3, Daniel Sur1,2, Andra Piciu1,2, Andra Stan6, Alina Bereanu5*, Florina Gabor-Harosa7, Iulia Zehan8,9, Ana Teodora Havasi10*, Simone Cainap4
1“Prof Dr. Ion Chiricuta” Institute of Oncology, Cluj-Napoca, Romania.
2Department of Oncology, “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania.
3Research Center for Functional Genomics, Biomedicine and Translational Medicine, University of Medicine and Pharmacy Iuliu Hatieganu, Cluj-Napoca, Romania.
4Department of Mother and Child, “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania.
5Faculty of Medicine, “Lucian Blaga”University of Sibiu, Sibiu, Romania.
6Department of Neuroscience, “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania.
7Community Medicine Department University of Medicine and Pharmacy “Iuliu Haţieganu” Cluj-Napoca, Romania.
8Department of Cardiology, “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania.
9“Nicolae Stăncioiu” Heart Institute, Cluj-Napoca, Romania.
10County Emergency Hospital, Oradea, Romania.
11MedEuropa Radiotherapy Center, Oradea, Romania.
*These authors contributed equally to this article.
Summary
Purpose: Advanced and metastatic cholangiocarcinoma prognosis is poor, and current palliative treatment is limited. The present study aimed to analyze the prognostic factors for survival in patients with advanced cholangiocarcinoma treated by various lines of chemotherapies.
Methods: The clinical data of 120 consecutive patients with cholangiocarcinoma treated between January 2008 and December 2018 at one comprehensive cancer center were retrospectively analyzed. Survival curves were drawn using the Kaplan-Meier method. The log-rank test was used for survival analysis.
Results: The progression-free survival in the first-line treatment was 5.6 months. Almost half of the first-line therapy patients received a second-line regimen with a progression-free survival of 3.8 months. In patients treated with third-line regimens, the progression-free survival was 6.8 months, however, only 20.53% of the initial patient cohort was eligible for third-line treatments. Time to treatment failure was 9.37 months, and overall survival was 12.73 months. No correlation was found between body mass index, gender, and progression-free survival, or overall survival. The type of metastasis seemed not to influence the survival rate or time to treatment failure.
Conclusions: Tumor extent at diagnosis influences the prognosis of advanced cholangiocarcinoma. First-line treatment selection impacts second-line survival and overall survival. Different chemotherapy regimens are equally effective in assuring tumor control. Neutrophil to lymphocyte ratio (NLR) is associated with poor prognosis.
Key words: cholangiocarcinoma, hepatobiliary, prognosis, chemotherapy, survival.
Full Text: PDF