DEMOGRAPHIC AND CLINICAL CHARACTERISTICS, AND DIAGNOSTIC-THERAPEUTIC MANAGEMENT OF PATIENTS WITH CHOLANGIOCARCINOMA AT A TERTIARY CARE CENTER

Introduction and Objectives

Cholangiocarcinoma is an aggressive malignancy of the biliary tract that is frequently diagnosed at advanced stages, limiting access to curative treatment.

Describe the clinical profile, diagnostic workup, therapeutic strategies, and outcomes in patients treated for cholangiocarcinoma.

Materials and Methods

A retrospective, descriptive, cross-sectional analysis was conducted on 30 patients with a confirmed diagnosis of cholangiocarcinoma between 2020 and 2024. Variables included demographic details, clinical features, diagnostic modalities, treatment received, and survival outcomes. Statistical analysis was performed using descriptive statistics, medians and interquartile ranges for continuous variables and absolute and relative frequencies for categorical data.

Results

Most patients were male (63.3%) with a mean age of 66 ± 9.1 years. Perihilar tumors were the most frequent subtype (46.7%), followed by intrahepatic tumors (36.7%). Jaundice (73.3%) and abdominal pain (56.7%) were the most common presenting symptoms. A history of smoking (60%) and alcohol use (40%) was frequent. Diagnostic imaging was initiated with ultrasound in 93.3% of cases complemented by CT scans (83.3%) and MRCP (70%). Elevated CA 19-9 levels were observed in 80% of patients. Only 23.3% of patients were eligible for curative surgery. Most received palliative chemotherapy. Biliary drainage was required in 43.3%. Overall survival was 43% at one year and declined to 20% at two years.

Conclusions

These results highlight the need for earlier recognition and timely referral to specialized, multidisciplinary centers to improve the management and prognosis of this challenging disease.

Conflict of interest: None

Clinical and Diagnostic Finding	Frequency / Percentage
Total patients	30
Most common type	Perihilar (n=14, 46.7%)
Average age	66 ± 9.1 years
Male sex	n=19 (63.3%)
Jaundice	n=22 (73.3%)
Abdominal pain	n=17 (56.7%)
Weight loss	n=15 (50%)
Primary sclerosing cholangitis	n=4 (13%)
Chronic liver disease	n=8 (26.7%)
Smoking	n=18 (60%)
Alcohol use	n=12 (40%)
Ultrasound as initial study	n=28 (93.3%)
Computed tomography	n=25 (83.3%)
MR cholangiography	n=21 (70%)
ERCP performed	n=17 (56.7%)
Elevated CA 19-9	n=24 (80%)
Eligible for curative surgery	n=7 (23.3%)
Chemotherapy (cisplatin + gemcitabine)	n=17 (56.7%)
Biliary drainage (endoscopic / IR)	n=11 (38%) / n=19 (62%)
Palliative care only	n=6 (20%)
12-month survival	n=13 (43%)
24-month survival	n=6 (20%)