Evaluation of surgical approach for extrahepatic cholangiocarcinoma
Qian-Feng Shi1, Ting-Bo Liang, Yun-Sheng Qin
1Department of Hepatobiliary and Pancreatic Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.
Background:
The incidence of extrahepatic cholangiocarcinoma increases in recent years. But the diagnosis and treatment are still troublesome to surgeons. This study was designed to explore the value of surgical approach in the treatment of extrahepatic cholangiocarcinoma.
Methods:
We retrospectively analyzed the clinical data of 135 patients with extrahepatic cholangiocarcinoma who had been treated in our hospital from January 1992 to December 2006.
Results:
The ratio of extrahepatic cholangiocarcinoma to biliary duct diseases was 1.81%. The rates of total resection and radical resection were 70.75% (75/106) and 56.60% (60/106), respectively. The overall 1-, 3-, 5-year survival rates were 46.93%, 37.33% and 18.75%, respectively. The 1-, 3-, 5-year survival rates were better in the radical resection group (74.94%, 55.74% and 41.27%, respectively) than in the palliative resection group (42.86%, 26.79% and 26.79%, respectively) (P<0.05). The survival rates of patients who had undergone palliative resection were higher than those of patients who had been subjected to palliative drainage or non-operation: 1-, 3-, 5-year survival rates were 42.86%, 26.79%, 26.79% vs. 23.33%, 6.67%, 0 or 17.86%, 0, 0 (P<0.05). While the survival rates were not significantly different between palliative drainage and non-operation (P<0.05). Multivariate analysis revealed that the histopathological grades, TNM stages and modalities were key factors influencing the outcome.
Conclusions:
The outcome of the patients with extrahepatic cholangiocarcinoma is still not optimistic. Radical resection is the first choice for the treatment of tumors.
