Improvement of Survival Outcomes of Cholangiocarcinoma by Ultrasonography Surveillance: Multicenter Retrospective Cohorts

Abstract

IntroductionMost cholangiocarcinoma (CCA) patients present with late stage of disease because of the difficulty to diagnosis at an early stage, resulting in poor survival of CCA patients. The Cholangiocarcinoma Screening and Care Program showed that ultrasound screening was an effective tool for detecting early stage CCA. This study aims to evaluate the survival outcome of patients diagnosed by ultrasound screening (US) compared to walk-in symptomatic patients.Methods5-year survival rates (5-YSR) and median survival time (MST) of CCA were calculated using Log-Rank test. Multivariate analyses were performed for significant factors from univariate analyses.ResultsA total of 711 histologically proven CCA cases were examined including ultrasound screening and walk-in groups. The screening group having 5-YSR was 53.9%, and MST was of 67.2 months, while walk-in group, the 5-YSR was 21.9% and MST was 15.6 months (p<0.001). In addition, multivariate analyses revealed that screening program was an independent factor to predict a good outcome of CCA patients when compared with walk-in group (p= 0.014).ConclusionUS is an effective tool for detecting early stage CCA leading to improve clinical outcome of CCA patients. Practically, US should be considered as a first tool for screening CCA in risk populations.Author SummaryMost cholangiocarcinoma (CCA) patients in Thailand have poor survival due to late-stage detection and patients walk-in to hospital with any symptoms. This study purpose to evaluate the survival outcome of CCA patients diagnosed by ultrasound screening (US). We found that US provided early stage and improved survival of CCA patients.