Surgical outcomes of multicentric adenocarcinomas of the biliary tract
Shin Kobayashi1, Masaru Konishi, Yuichiro Kato
1Department of Surgical Oncology, National Cancer Center Hospital East, Kashiwa, Chiba, Japan.
Objective:
In comparison to single biliary cancers, distinct features of biliary multicentric adenocarcinomas are not yet clear.
Methods:
From July 1992 to July 2009, 393 patients underwent surgery for cancers of the biliary tract at the National Cancer Center Hospital East, Kashiwa, Japan. Clinicopathological characteristics and surgical outcomes of multicentric biliary adenocarcinoma were compared with those of single cancers.
Results:
During the period, 10 cases (2.5%) with multicentric cancer (6 synchronous and 4 metachronous cancers) were found among 393 cases of biliary cancer. Pathologically, compared with single cancers, multicentric adenocarcinomas were more likely to be early cancers and to be papillary carcinomas with both superficial epithelial tumor spread and extensive dysplastic epithelium, but were less likely to have lymph node metastases (P < 0.01). The proportion of multicentric cancers among early papillary cancers was high (9/24, 37.5%). Clinically, no recurrences were detected in lymph nodes, peritoneum or distant organs, but one recurrence in the remnant bile duct. Only one patient died from cancer progression. The overall survival of patients with multicentric adenocarcinomas was statistically the same as that of single cancers (median survival: 69 vs. 30 months, P = 0.47).
Conclusions:
Multicentric adenocarcinomas of the biliary tract have distinct features compared with single cancers.
