Cancer of the extrahepatic biliary tract are almost always accompanied by an unfavorable prognosis. In most cases, the resectability rate is low bacause of the direct extension of the tumor to the adjacent vital organs. Even though the recent
advancement of diagnosis and therapy, the management of these patients is still an extremely problem at the present time.
A clinical analysis was performed in 187 cases of extrahepatic bile duct cancer operated over 2 16 years period at Pusan Gospel Hospital, Department of General Surgery from Jan. 1975 to Dec. 1990.
To evaluate the significance of prognostic factors, we analysed retrospectively the survival rates of 54 cases of radical resection group, according to operative procedures, histological types, locations and stages, According to the operative
procedures, resection and biliary-enterostomy group(34 cases) had 20% of 5 year survival rate(5 YSR), and Whipple's operation group (20 cases) has 27.5% of 5 YSR. Papillary adenocarcinomas(16 cases) showed significantly better survival than
poorly-differentiated adenocarcinomas(95 cases)(45% vs 0% in 5 YSR). Middle and lower third lesions has 22.5% and of 5 YSR respectively, but upper third and diffuse lesions has no survivors after 3 years. Also, the extension of malignancy to
reginal
lymph node is important prognostic indicators. Node negative groups(39 cases) had 35% of YSR, but node positive group( 15 cases) had no survivors after 3 years.
Conclusively, our data suggest that the histologic types, locations and nodal invasion strongly influence the prognosis of the patients with extrahepatic bile duct cancer.
|