Survival of patients with unresectable cholangiocarcinoma undergoing palliative chemotherapy - real world data from a German tertiary care center

Introduction Incidence and mortality of cholangiocarcinoma (CCA) have been rising globally. Real world data on the overall survival (OS) of patients receiving sequential palliative chemotherapy (pCTX) are lacking. Moreover, evidence about therapeutic options and their efficacy following the standard-of-care first- and second-line therapy with gemcitabine/cisplatin and FOLFOX is limited.

Objective This retrospective study aimed to analyze the OS of patients with unresectable CCA undergoing pCTX regarding different oncological treatment regimens and to determine prognostic factors.

Methods From January 2010 until December 2019, a total of 142 patients with unresectable CCA received pCTX at our tertiary care center. OS was analyzed by using Kaplan-Meier plots. Prognostic factors were identified by using cox proportional hazards.

Results Patients were treated with a median of two pCTX lines. Median OS was 6.7, 15.2 and 18.2 months for patients undergoing one, two or three pCTX lines, respectively. Treatment with FOLFIRINOX was associated with a significant extended OS of 23.8 months (log-rank test p = 0.018).

Several clinical parameters, including albumin, bilirubin, CEA, CA19-9 levels, were associated with OS as identified by univariate cox regression analysis.

Conclusion This study yields real world data regarding the prognosis of patients with unresectable CCA, including OS times for third and later pCTX lines. Moreover, pCTX with FOLFIRINOX seems to confer a significant OS benefit.

Publication History

Article published online:
07 September 2021