[Prognostic factors for surgical treatment of hilar biliary cancer]

Forty-five patients with hilar biliary cancers were operated on at our department. The tumor was resected in 29 patients (64%). There were no operative deaths and the survival rate was 41% and 21% at 12 and 24 months respectively. In patients with no tumor resection the 60-day mortality rate was 37.5% and none of them survived for 12 months. Significant difference was noted in survival rates of the patients with radical resection, those with resection of marginal cancer and those with palliative resection. 28% of the patients with radical resection survived for 18 months but none of patients with resection of marginal carcinoma survived for 18 months. Most patients with tumor resection died from tumor recurrence or reappearance of jaundice 6 to 12 months after operation. There was no significant difference between the type of tumor and the degree of cancer invasion. We conclude that liver resection of hilar cholangiocarcinoma may give a long survival rate if no marginal tumor is left. Surgical treatment should be dependent on the invasion of hilar carcinoma and extended liver resection.