title: Prognostic factors for radical resection of middle and distal bile duct cancer.
abstract: OBJECTIVE
  Prognostic factors after radical operation for middle and distal bile duct cancer are not fully understood. The aim of this study is to identify prognostic factors for patients undergoing radical operation for middle and distal bile duct cancer.
  
  
  METHODS
  The records of 57 patients with middle (n=22) and distal (n=35) bile duct cancer who had undergone radical surgery were reviewed (pancreaticoduodenectomy in 46 patients, extrahepatic bile duct resection in 6, and major hemihepatectomy in 5). The clinicopathological prognostic factors affecting survival were examined.
  
  
  RESULTS
  The 5 years survival rate was 36% (median survival time, 34 months). Significant prognostic factors according to univariate analysis include pT classification, papillary type, number of metastatic lymph node, positive radial margin, pancreatic invasion, lymphatic invasion, venous invasion, common hepatic node metastasis, paraaortic node metastasis, and combined vascular resection. Independent significant prognostic factors according to multivariate analysis include the number of metastatic lymph nodes (5 or more), positive radial margin, and common hepatic node metastasis.
  
  
  CONCLUSIONS
  The number of metastatic lymph nodes, common hepatic node metastasis, and positive radial margin are independent prognostic factors for middle and distal bile duct cancer. The surgical treatment of middle and bile duct cancer should achieve a negative radial margin for a favorable outcome.
authors: Division of Surgery, Niigata Cancer Center Hospital, 2-15-3 Kawagishi-cho, Chuo-ku Niigata City 951-8566, Japan. nomurat@niigata-cc.jp
authors: Tatsuya
authors: T
authors: Nomura
authors: Yoshiaki
authors: Y
authors: Tsuchiya
authors: Atsushi
authors: A
authors: Nashimoto
authors: Hiroshi
authors: H
authors: Yabusaki
authors: Yasumasa
authors: Y
authors: Takii
authors: Satoru
authors: S
authors: Nakagawa
authors: Nobuaki
authors: N
authors: Sato
authors: Chizuko
authors: C
authors: Kanbayashi
authors: Otsuo
authors: O
authors: Tanaka
mesh_terms: D000328:Adult; D000368:Aged; D001650:Bile Duct Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D016577:Pancreaticoduodenectomy; D011379:Prognosis; D016016:Proportional Hazards Models; D015996:Survival Rate; D016896:Treatment Outcome