ackground : Hepatocellular carinoma (HCC) with major bile duct invasion is a particular
type that invades and ruptures into the bile duct in the early stage of HCC. It will be
different from the other types of HCC in the clinical characterictics, progonosis and prognostic
factors.
Method : We investigated 16 patients, who were confirmed to have major bile duct
invation by surgical pathology (6 cases), cholangiogram (7 cases), or computed tomography (3
cases), to find clinical features and to evaluate prognosis and prognostic factors affecting the
mean survival time.
Results :
1) Sixteen (2.8%) of 566 patients with HCC were associated with major bile duct invasion.
2) The macroscopic types of tumor by computed tomography were nodular in 6, infiltrative
in 8, and invisible in 2 cases.
3) The mean survival time of 16 patients was 3.3 months.
4) weight loss (>10%) and infiltrative tumor type were correlated to poor prognosis.
However, age, total bilirubin, alpha-fetoprotein, and HBsAg positivity did not affect the
survival time.
Conclusion : In our series, the frequency of HCC with major bile duct invasion was not
uncommon and the infiltrative tumor type was more frequent than the nodular tumor type.
The assessment of weight loss and gross tumor type can identify some prospect of prolonged
survival in patients with HCC showing major bile duct invasion.
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