Clinicopathological Study on the Long Term Survivors Following Resection of Hilar Bile Duct Cancer

• Published in: Nippon Shokaki Geka Gakkai zasshi Vol. 24; no. 6; pp. 1341 - 1350
• Main Authors: Todoroki, Takeshi, Kawamoto, Toru, Koike, Naoto, Orii, Kazuo, Otsuka, Masaaki, Ueda, Hiroshi, Kawai, Yuichi, Okamura, Takao, Iwasaki, Yoji
• Format: Journal Article
• Language: English; Japanese
• Published: The Japanese Society of Gastroenterological Surgery 1991
• Subjects: clinicopathological study on the long term survivors; hilar bile duct cancer; more than 5 years survivors
• ISSN: 0386-9768; 1348-9372
• DOI: 10.5833/jjgs.24.1341

57 patients underwent tumor resection for hilar bile duct cancer and 13 of them received curative and 44 noncurative resection. Out of the 57, 9 patients (Stage II, 1; III, 3; IV, 5) have alived for more than 5 years following curative (6), or noncurative (3) resection. Resection procedures for the 9 survivors consisted of hilar bile duct resection (HBDR) for 2 patients, HBDR + pancreatoduodenectomy for one, HBDR + Ext. right hepatic lobectomy + SI resection for one and HBDR + Ext. left hepatic lobectomy +/-SI resection for 5 patients. Examination for extent of cancer invasion into the bile duct wall revealed that one had invasion within the adventitia and 4 had invasion into the adjacent organs. In terms of direct extension into the hepatic parenchyma, 4 of 9 (55.6%) had direct extension. While, 3 of 9 patients had lymph node metastasis. Out of the 9 survivors, one had a positive surgical margin at the hepatic duct and 3 had a positive margin at the site opposite the mucosal surface. The incidence of positive margins in the survivors for more than 3 years (n=13) was significantly (p<0.05) lower than that in the patients who dead in less than 3 years (n=36). These results indicate the importance of the negative margins in achieving long term survival following tumor resection.