title: Clinical outcome and long term results after surgical treatment of biliary cystadenoma and cystadenocarcinoma.
abstract: OBJECTIVE
  Biliary cystadenoma (BCA) and cystadenocarcinoma (BCCA) are rare cystic hepatic neoplasms. Prior reports concerning the proper surgical treatment and long-term survival are scarce. We report our experience and survival outcome of 30 patients over the last 25 years.
  
  
  METHODS
  We retrospectively reviewed the clinicopathologic data of the pathologically confirmed 18 BCA and 12 BCCA patients, who underwent operations from 1983 to 2006, at the Seoul National University Hospital.
  
  
  RESULTS
  The patients consisted of 8 men and 22 women with a mean age of 51 years. With abdominal computed tomography scans, 73.3% (n=22) were preoperatively diagnosed as BCA or BCCA, and differentiating BCCA from BCA was accurate in 58.3% patients. R0 resection was achieved in 90% (n=27). The differentiating factors included the presence of mural nodule (4/18 vs. 8/12; p=0.009) and mucinous content (2/9 vs. 8/1; p=0.005), and tumor size tending to be larger in BCCA (11.7 cm vs. 7.9 cm; p=0.067). Overall 5-year and 10-year survival rates of BCCA were 72.9% and 60.9%, respectively. Of patients with BCCA, 4 experienced recurrence. In case of recurrence, patients tended to be younger than 50 years (p=0.061) and the lesions tended to be larger than those without recurrence (p=0.088).
  
  
  CONCLUSIONS
  Preoperative differentiations of BCA from simple cyst, and BCCA from BCA are still difficult. Complete removal of the tumor, via major hepatectomy, should be considered, especially in the younger age group with large tumor.
authors.affiliation: Department of Surgery & Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Youngpeck
authors.initials: Y
authors.lastname: Song
authors.affiliation: Department of Surgery & Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Mee Joo
authors.initials: MJ
authors.lastname: Kang
authors.affiliation: Department of Surgery & Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Jin-Young
authors.initials: JY
authors.lastname: Jang
authors.affiliation: Department of Surgery, Konkuk University College of Medicine, Seoul, Korea.
authors.forename: Kuhn Uk
authors.initials: KU
authors.lastname: Lee
authors.affiliation: Department of Surgery & Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Kyung Suk
authors.initials: KS
authors.lastname: Suh
authors.affiliation: Department of Surgery & Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Sun-Whe
authors.initials: SW
authors.lastname: Kim
keywords: Biliary tract; Cyatadenoma; Cystadenocarcinoma; Malignancy; Survival rate