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Related Experiment Videos

Improved survival in resected biliary malignancies.

Attila Nakeeb1, Khoi Q Tran, Michael J Black

  • 1Departments of Surgery, Radiation Oncology, Medicine, and Radiology, Medical College of Wisconsin, Milwaukee, Wis 53226, USA.

Surgery
|October 31, 2002
PubMed
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Improved surgical techniques and chemoradiation have significantly enhanced survival rates for patients with biliary malignancies. Aggressive surgery aiming for negative margins, combined with modern staging and stenting, offers better outcomes for resectable cases.

Area of Science:

  • Oncology
  • Surgical Gastroenterology
  • Hepatobiliary Surgery

Background:

  • Biliary malignancies historically have a poor prognosis.
  • Advances in radiology, laparoscopy, and biliary stenting aid in staging and patient management.
  • Surgical goals have shifted from gross tumor excision to achieving negative microscopic margins.

Purpose of the Study:

  • To evaluate if survival has improved for biliary malignancy patients.
  • To assess the impact of enhanced staging, biliary stent management, aggressive surgery, and chemoradiation on patient outcomes.

Main Methods:

  • Analysis of 140 patients with biliary malignancies (cholangiocarcinomas and gallbladder cancers) treated from 1990-2001.
  • Evaluation of surgical exploration, resection rates, and the use of chemoradiation (confocal radiation, 5-fluorouracil, gemcitabine) since 1998.

Related Experiment Videos

  • Comparison of survival data between patients resected in different time periods.

    • Main Results:

    • Operative mortality was 4%.
    • For resected patients (n=44), 5-year survival was 31% (median survival 27.8 months).
    • Patients resected between 1998-2001 (n=25) showed significantly improved outcomes (median survival >44 months, 3-year survival 70%) compared to those resected 1990-1997 (median survival 13 months, 3-year survival 21%; P <.01).

    Conclusions:

    • Approximately one-third of patients with biliary malignancies present with resectable disease.
    • Adjuvant chemoradiation combined with surgery in selected patients has improved survival.
    • Improved staging, biliary stenting, extensive surgery for negative margins, and modern chemoradiation techniques contribute to better outcomes.