Background: Cholangiocarcinoma (CCA) is a rare primary liver cancer in most part of the world, however it is the major liver cancer in the Northeast region of Thailand. Hilar cholangiocarcinoma (HCA), is the most common type of CCA, commonly presents with cholestasis, Majority of HCA is in an inoperable stages. This study aimed to analyze factors that predict survival of inoperable HCA in the high patient-loaded-center.

Materials and Methods: The study analyzed the data from hilar cholangiocarcinoma registry of 273 HCA. The survival time (Kaplan-Meier) was analyzed in association with age, sex, underlying diseases, liver function tests, level of CEA and CA19-9, Bismuth-Corlette type, staging and methods of treatment. Univariate and multivariate analyses were performed.

Results: The poor prognostic factors were clinical presentation with jaundice, ECOG performance status > 3, serum CA19-9>100 U/mL, serum CEA>30 ng/mL. Patients who had biliary drainage with ERCP and PTBD had reduced risk of death (hazard ratio [HR] 0.48, 95% confidence interval [CI] 0.25-0.90 and HR 0.40, 95% CI 0.24-0.69, respectively) 

Conclusion: Inoperable HCA has poor prognosis. Biliary drainage with either ERCP or PTBD can prolong the survival time.