[Palliative therapy of carcinomas of the biliary system].
CARCINOMA OF THE GALLBLADDER: Only patients suffering from advanced disease have symptoms, that is pain, jaundice, weight loss. Mean 5-year survival rate tends to be lower than 5%. Tumors can be resected with negative margins in 15 to 25% of the patients. Obstructive jaundice can be managed with endoscopic biliary stent in 84% of the patients. After radiotherapy tumor regression is observed in 80% of the patients. Their mean survival time is 10 months.
More than 90% of the patients present with jaundice. At the time of presentation, 50% of the patients already have metastases to lymph nodes. Mean total survival time of all patients is 12 months. Surgical resection can successfully be performed in 30 to 40% of the patients suffering from proximal cholangiocarcinomas. Distal unresectable tumors are best palliated with an endoscopically placed stent in 97.5% of the patients. Patients having undergone radiotherapy will have a mean survival time of 9 to 12 months. There is a 12% response rate after chemotherapy with single agents and one of 23% after combined regimens. Intraarterial application of chemotherapy results in 44% response rate.


CONCLUSIONS
Carcinomas of the biliary tract are often diagnosed at advanced inoperable stages. Patients quality of life can be ameliorated by palliative treatment, i.e. biliary stents, radio-, chemotherapy. Mean survival time does normally not exceed 1 year.
Lersch
C
C
II. Medizinische Klinik und Poliklinik, Technischen Universität München.
Classen
M
M
D001650:Bile Duct Neoplasms / Q000401:mortality / Q000628:therapy*; D001653:Bile Ducts, Intrahepatic; D018281:Cholangiocarcinoma / Q000401:mortality / Q000628:therapy*; D003131:Combined Modality Therapy; D005706:Gallbladder Neoplasms / Q000401:mortality / Q000628:therapy*; D006801:Humans; D010166:Palliative Care / Q000379:methods*; D011379:Prognosis; D015996:Survival Rate