[Multimodal treatment of cancer of the biliary tract]

The incidence of cancer of the biliary tract has been recently increasing, but the results of treatment have been unsatisfactory. During the last 10 years and 10 months, 128 cases of carcinoma of the biliary tract, including 64 cases of the gallbladder and the bile duct, respectively, were admitted. Some 98 (86%) out of the 113 cases were resected, with a low curative surgery rate of 32.7%. The curative surgery even resulted in recurrence with a few long-term survivors, so multimodal treatment should be considered for all cases. In non-curative resection, the 2-year cumulative survival rate of gallbladder carcinoma was 25% with radiation and chemotherapy, compared to the group without such treatment, all of whom died within 2 years after surgery. In cancer of the bile duct, similar results were obtained, so multimodal treatment should be administered especially in non-curative resection cases. In 1985 Mizumoto's group reviewed 1614 cases of gallbladder carcinoma and bile duct carcinoma collected from 22 institutions in Japan. The resectability and curative rate have been increasing, and the survival rates of both groups have slightly increased. Multimodal treatment has involved radiation therapy in 13.6% and chemotherapy in 44.1% of the cases. A two-year cumulative survival rate increased in non-curative resection patients treated with multimodal treatment.