From the Guidelines
Metastatic cholangiocarcinoma has a poor prognosis with a high mortality rate, with a median survival of approximately 3.9 months for patients who do not undergo surgery, chemotherapy, or radiotherapy 1. The mortality rate for metastatic cholangiocarcinoma is high due to the aggressive nature of the disease, its tendency to be diagnosed at advanced stages, and limited effective treatment options.
- The median survival for patients with metastatic cholangiocarcinoma can vary depending on several factors, including the patient's performance status, extent of metastatic disease, and response to treatment.
- First-line treatment typically involves systemic chemotherapy, but the most effective treatment regimen is still a subject of research.
- Patients often experience complications including biliary obstruction, liver failure, and cachexia as the disease progresses, contributing to mortality.
- The high mortality rate is also due to the limited understanding of the disease and the lack of effective treatment options, highlighting the need for further research and development of new therapies.
- Recent studies have shown that liver transplantation may be a viable option for some patients with metastatic cholangiocarcinoma, particularly those with early-stage disease and anatomically unresectable lesions 1.
- However, this approach is still experimental and should only be considered in the context of clinical trials or at highly specialized centers.
- Overall, the management of metastatic cholangiocarcinoma requires a multidisciplinary approach, taking into account the patient's individual needs and circumstances, and prioritizing palliative care and quality of life.
From the Research
Mortality for Metastasis Cholangiocarcinoma
- The mortality rate for metastatic cholangiocarcinoma is high, with a 5-year survival rate of less than 5% 2.
- The main causes of mortality in cholangiocarcinoma patients are cancer cachexia, liver failure, and recurrent sepsis due to biliary obstruction 2.
- The prognosis of cholangiocarcinoma remains poor even with aggressive surgical therapy due to the high incidence of local or regional recurrence and distant metastasis 2.
- For patients with advanced intrahepatic cholangiocarcinoma, the prognostic value of site-specific metastases varies, with regional lymph nodes metastases having the best prognosis, followed by liver metastases, and then bone metastases 3.
- The use of gemcitabine and cisplatin as neo-adjuvant therapy prior to liver transplantation has shown promising results, with a median overall survival of 100% at one and two years, and 75% at three to five years 4.
- Chemotherapy with gemcitabine and cisplatin is currently the standard palliative treatment for unresectable or metastatic cholangiocarcinoma, and can prolong overall survival by 3.6 months compared to monotherapy with gemcitabine 5, 6.