Early Survival Advantage Discerned in Bile Duct Cancer

A new study has reported the discovery of an early survival advantage when a combination of surgery and radiation therapy is used for patients with locoregional extraheptitc cholangiocarcinoma (EHCC), a rare cancer of the bile ducts.

Researchers at the Oregon Health & Science University (OHSU, Portland, USA) studied a total of 2,591 cases of EHCC diagnosed between 1973 and 1998 that were taken from the Surveillance, Epidemiology and End Results (SEER) program of the U.S. National Cancer Institute (Bethesda, MD, USA). Cases were sorted into surgery alone; radiotherapy alone; surgery and radiotherapy; and neither surgery nor radiotherapy.

The researchers found that early survival increased when surgery and radiation were combined. Those receiving both treatments were more likely to survive the first two years after diagnosis, even though the five-year survival remained similar for both groups. The addition of radiation to surgery was also associated with increased median survival. The study was presented at the annual meeting of the American Society of Therapeutic Radiology and Oncology, held during October 2007 in Los Angeles (CA, USA).

"We're not sure why this early survival benefit disappears. It could be that radiation delays the progression of the disease, and delays disease progression, but we don't know for sure,” said lead author Clifton David Fuller, M.D., Ph.D. "However, in the absence of clinical trial data, it is reasonable to suggest radiation plus surgery or surgery alone as the prescribed treatment for this cancer, given our observations. Patients selecting treatment should ask their doctors whether radiation should be added to surgery in their particular cases.”

Patients with EHCC typically experience symptoms at advanced stages, and cure rates are low even with aggressive therapy. Prognosis is extremely poor, with an average five-year survival rate of five to ten percent. The reported incidence of cholangiocarcinoma is one to two cases per 100,000 people in the United States.


Related Links:
Oregon Health & Science University
U.S. National Cancer Institute