title: Carcinoma of the extrahepatic biliary system: correlation of clinical, pathological, histological and DNA-cytometric parameters with prognosis.
abstract: BACKGROUND
  Studies concerning the prognosis of all carcinomas of the extrahepatic biliary system together (EBC) do not exist, so far. A detailed and valid histopathological grading-system is lacking and the prognostic relevance of DNA-cytometric parameters is not clear.
  
  
  METHODS
  81 patients with EBC underwent surgical treatment. Clinical, pathological, histomorphological and DNA-cytometric parameters were evaluated. The influence on prognosis was tested in univariate and multivariate analysis.
  
  
  RESULTS
  Apart from significant perioperative mortality (17%) survival was markedly dependent on the presence of tumor remnants in resection margins. After incomplete and complete resection, the median survival was 5 and 19 months, respectively (p < 0.0001). Further parameters with significant prognostic relevance were tumor localization, pTNM-stage, period of complaints, presence of gallstones, histological type and DNA-index. Multivariate analysis however demonstrated only two independent prognostic factors: status of resection margins and tumor localization.
  
  
  CONCLUSIONS
  Histomorphological- and DNA-cytometric parameters failed to demonstrate an additional significant influence on the prognosis in EBCs. Apart from perioperative mortality, the survival of patients with EBC predominantly depends on tumor localization and the status of resection margins.
authors.affiliation: Department of Internal Medicine III, Technical University Aachen, Germany.
authors.forename: B G
authors.initials: BG
authors.lastname: Backes
authors.forename: S
authors.initials: S
authors.lastname: Hauptmann
authors.forename: A
authors.initials: A
authors.lastname: Böcking
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D001650:Bile Duct Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D017734:Bile Ducts, Extrahepatic / Q000473:pathology; D004273:DNA, Neoplasm / Q000032:analysis*; D005260:Female; D005706:Gallbladder Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008297:Male; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis
chemical_list: D004273:DNA, Neoplasm