title: Treatment of borderline cases for curative resection of biliary tract cancer.
abstract: OBJECTIVE
  To dissect the high rate of non-curative resection associated with biliary tract cancer, we compared the outcome of non-curative resection with that of inoperable cancer in patients referred for surgery.
  
  
  METHODS
  We retrospectively analyzed 447 patients with biliary tract cancer who were referred to our hospital between 1970 and 2008. We compared the background and overall survival (OS) rates accordingly to surgery (curative resection, non-curative resection, or no surgery "inoperable") and alternative therapies (chemotherapy and/or radiotherapy).
  
  
  RESULTS
  The 3-year OS rate was 19% for the non-curative resection group (n=72) and 2% for the inoperable group (n=135, P<0.0001). Among the inoperable cases, the 3-year OS rate for patient who received chemotherapy, including gemcitabine (GEM), was 18% (n=18), which was similar to that of patients of the non-curative resection who were treated with GEM (P=0.7379). There were no significant differences in survival between non-curative resection without GEM and inoperable cases with GEM-based chemotherapy.
  
  
  CONCLUSIONS
  Our results indicate that the prognosis of patients who undergo non-curative surgery is better than those with inoperable cancer, but similar to those who receive chemotherapy including GEM.
authors.affiliation: Department of Surgery, Osaka University, Suita, Osaka, Japan.
authors.forename: Shogo
authors.initials: S
authors.lastname: Kobayashi
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Nagano
authors.forename: Shigeru
authors.initials: S
authors.lastname: Marubashi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Wada
authors.forename: Hidetoshi
authors.initials: H
authors.lastname: Eguchi
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Takeda
authors.forename: Masahiro
authors.initials: M
authors.lastname: Tanemura
authors.forename: Koji
authors.initials: K
authors.lastname: Umeshita
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Doki
authors.forename: Masaki
authors.initials: M
authors.lastname: Mori
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use*; D001661:Biliary Tract Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D001918:Brachytherapy; D015331:Cohort Studies; D003131:Combined Modality Therapy; D003841:Deoxycytidine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome; D000093542:Gemcitabine
chemical_list: D000964:Antimetabolites, Antineoplastic; D003841:Deoxycytidine; D000093542:Gemcitabine