| บทคัดย่อ |
Cholangiocarcinoma(CCA) is the most common primary liver cancer in the northeast region of Thailand. Most CCA patients see a physician in the late stage of disease when curative surgery is not possible .After diagnosis, patients are treated by partial surgery/percutaneous drainage, chemotherapy and supportive treatment.This study used a retrospective cohort design to assess the survival rate of CCA patients in Northeastern Thailand after supportive treatment. Data on 746 CCA patients were extracted from the hospital-based cancer registry in the Faculty of Medicine, KhonKaen University, at Srinagarind Hospital. The patients had all been registered between 1 January, 2009 and 31 December, 2010, after diagnosis by a physician based on at least a laboratory examination and ultrasonography. The current status of the patients was followed up from medical records and the Population Registration Database, Ministry of Interior, until 30 June, 2011.The cumulative survival rate was calculated by the Kaplan-Meier method, and independent prognostic factors were investigated using Cox regression.The total follow up time was 5,878 person-months, and the total number of deaths was 637. The mortality rate was therefore 10.8 per 100 person-year (95%CI = 10.1to 11.7). The cumulative 3, 6, 9, 12 and 24 month survival rates were 59%(95%CI = 55.5 to 62.6), 39%(95%CI = 35.1 to 42.1), 31%(95%CI = 27.4 to 34.1), 24%(95%CI = 20.9 to 27.0) and 14%(95%CI = 11.6 to 17.1), respectively.The median survival time after supportive treatment was 4 months. After adjusting for gender, age, stage, distant metastasis, histological grading and treatment, stage was a significant predictor of the survival of CCA patients after supportive treatment. Patients who were in Stage III and Stage IV had a 6.78 fold higher mortality than who were in Stage I and Stage II (95%CI = 1.60 to 28.70).Summary, stage is an important risk factor affecting survival of CCA patients after supportive treatment. |
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