[Long-term results of 84 surgically treated patients with extrahepatic bile duct carcinoma].
OBJECTIVE
Extrahepatic bile duct carcinoma is a rare but dismal malignacy. This study is conducted to show retrospective review and analysis of the correlation between the prognosis and different treatment modalities.


METHODS
The data of 84 such patients treated by different modalities from January, 1992 to July, 2000 were retrospectively reviewed and analyzed using SPSS 10.0 statistical package. The survivals were estimated by the Kaplan-Meier method and the difference among groups was tested by the log-rank test. The prognostic factors were determined by Cox multivariate analysis.


RESULTS
Of the 84 patients, 33 had complete resection, 19 palliative resection, 12 exploration alone, and the remaining 20 were treated by chemotherapy and/or radiotherapy. The mean follow-up time was 592 days. The overall 5-year survival rate was 13.1%. The 1-, 3- and 5-year survival rate following complete resection was 76.8%, 52.6% and 30.5% respectively, which was significantly higher than those of palliative surgery or chemotherapy/radiotherapy (P < 0.01). Multivariate analysis revealed that lymph node status (P = 0), histopathological grade (P = 0.001) and distant metastasis (P = 0.002) were significant high risk factors.


CONCLUSIONS
The prognosis of extrahepatic bile duct carcinoma remains poor even after complete resection as shown to have a 5-year survival of 30.5%. More effective adjuvant therapy is needed. Extended resection may be helpful in improving the prognosis for carefully selected patients. Early diagnosis and early treatment is still the key to improve the long-term survival of extrahepatic bile duct carcinoma.
Zheng
Shu-sen
SS
Department of Hepatobiliary Pancreatic Surgery, First Hospital, Medical College, Zhejiang University, Hangzhou 310003, China.
Qin
Yun-sheng
YS
Liang
Ting-bo
TB
Huang
Dong-sheng
DS
Zhang
Min
M
Wang
Wei-lin
WL
Shen
Yan
Y
Wang
Jin-hai
JH
D000230:Adenocarcinoma / Q000401:mortality / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001650:Bile Duct Neoplasms / Q000401:mortality / Q000601:surgery*; D017734:Bile Ducts, Extrahepatic / Q000601:surgery*; D001662:Biliary Tract Surgical Procedures / Q000379:methods / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome