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AIM:To study the factors that may affect survival of cholangiocarcinoma in Lebanon.METHODS:A retrospective review of the medical records of 55 patients diagnosed with cholangiocarcinoma at the American University of Beirut between 1990 and 2005 was conducted.Univariate and multivariate analyses were performed to determine the impact of surgery,chemotherapy,body mass index,bilirubin level and other factors on survival.RESULTS:The median survival of all patients was 8.57 mo (0.03-105.2).Univariate analysis showed that low bilirubin level (＜10 mg/dL),radical surgery and chemotherapy administration were significantly associated with better survival (P = 0.012,0.038 and 0.038,respectively).In subgroup analysis on patients who had no surgery,chemotherapy administration prolonged median survival significantly (17.0 mo vs 3.5 too,P = 0.001).Multivariate analysis identified only low bilirubin level ＜ 10 mg/dL and chemotherapy administration as independent predictors associated with better survival (P ＜ 0.05).CONCLUSION:Our data show that palliative and postoperative chemotherapy as well as a bilirubin level ＜ 10 mg/dL are independent predictors of a significant increase in survival in patients with cholangiocarcinoma.