[Prognostic factors after major resection for distal extrahepatic cholangiocarcinoma].
OBJECTIVE
Although diagnosis and surgical treatment for distal common bile duct cancer have enormously advanced, survival is not satisfactory and its prognostic factors are still being debated. Thus, we evaluated the outcomes and prognostic factors after major resection for distal extrahepatic cholangiocarcinoma (dCC).


METHODS
One hundred and fifty-four patients who underwent major resection such as pancreatic oduodenectomy for dCC were retrospectively analyzed. We investigated clinical features, postoperative complications, survival, and prognostic factors of dCC.


RESULTS
One hundred and three (66.9%) male and 51 (33.1%) female patients were enrolled and their mean age was 59.6 (31-78) years. Among them, 97 patients (63.0%) underwent Whipple's procedure, 45(29.2%) pylorus-preserving pancreatic oduodenectomy, 7 (4.5%) total pancreatectomy, and 5 (3.3%) hepatopancreaticoduodenectomy, respectively. Mean follow-up duration was 26.6 (0.4-108.5) months. The postoperative morbidity and mortality were 42.2% and 1.3%, respectively. Five-year survival rate was 32.8% and mean survival duration was 47.2 (39.1-55.3) months. Type of biliary drainage (percutaneous transhepatic biliary drainage), lymph node status (positive), and cellular differentiation (moderate or poor) were significant indicators for death in multivariate analysis of resectable dCC.


CONCLUSIONS
Moderate or poor cellular differentiation and lymph node metastasis maybe independent poor prognostic factors for resectable dCC.
Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Gangnam-gu, Seoul, Korea.
Jeoung Woo
JW
Kim
Sungho
S
Jo
Hyoun Jong
HJ
Moon
Jin Seok
JS
Heo
Seong Ho
SH
Choi
Jae Won
JW
Joh
Dong Wook
DW
Choi
Jun Chul
JC
Chung
Yong Il
YI
Kim
D000328:Adult; D000368:Aged; D001650:Bile Duct Neoplasms / Q000401:mortality / Q000601:surgery*; D017734:Bile Ducts, Extrahepatic; D001662:Biliary Tract Surgical Procedures; D018281:Cholangiocarcinoma / Q000401:mortality / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012307:Risk Factors; D015996:Survival Rate