title: Surgical outcomes of multicentric adenocarcinomas of the biliary tract.
abstract: OBJECTIVE
  In comparison to single biliary cancers, distinct features of biliary multicentric adenocarcinomas are not yet clear.
  
  
  METHODS
  From July 1992 to July 2009, 393 patients underwent surgery for cancers of the biliary tract at the National Cancer Center Hospital East, Kashiwa, Japan. Clinicopathological characteristics and surgical outcomes of multicentric biliary adenocarcinoma were compared with those of single cancers.
  
  
  RESULTS
  During the period, 10 cases (2.5%) with multicentric cancer (6 synchronous and 4 metachronous cancers) were found among 393 cases of biliary cancer. Pathologically, compared with single cancers, multicentric adenocarcinomas were more likely to be early cancers and to be papillary carcinomas with both superficial epithelial tumor spread and extensive dysplastic epithelium, but were less likely to have lymph node metastases (P < 0.01). The proportion of multicentric cancers among early papillary cancers was high (9/24, 37.5%). Clinically, no recurrences were detected in lymph nodes, peritoneum or distant organs, but one recurrence in the remnant bile duct. Only one patient died from cancer progression. The overall survival of patients with multicentric adenocarcinomas was statistically the same as that of single cancers (median survival: 69 vs. 30 months, P = 0.47).
  
  
  CONCLUSIONS
  Multicentric adenocarcinomas of the biliary tract have distinct features compared with single cancers.
authors.affiliation: Department of Surgical Oncology, National Cancer Center Hospital East, Kashiwa, Chiba, Japan.
authors.forename: Shin
authors.initials: S
authors.lastname: Kobayashi
authors.forename: Masaru
authors.initials: M
authors.lastname: Konishi
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Kato
authors.forename: Naoto
authors.initials: N
authors.lastname: Gotohda
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Takahashi
authors.forename: Takahiro
authors.initials: T
authors.lastname: Kinoshita
authors.forename: Taira
authors.initials: T
authors.lastname: Kinoshita
authors.forename: Motohiro
authors.initials: M
authors.lastname: Kojima
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology* / Q000601:surgery*; D000231:Adenocarcinoma, Papillary / Q000473:pathology / Q000601:surgery; D000328:Adult; D000368:Aged; D001661:Biliary Tract Neoplasms / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D007564:Japan; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000601:surgery; D018365:Neoplasm, Residual / Q000473:pathology / Q000601:surgery; D009378:Neoplasms, Multiple Primary / Q000473:pathology / Q000601:surgery; D016609:Neoplasms, Second Primary / Q000473:pathology* / Q000601:surgery*; D012086:Reoperation; D012189:Retrospective Studies; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome