Clinical Study on 193 Cases of Extrahepatic Bile Duct Carcinomaand Its Prognostic Factors

Joo, Yeon Ho; Myung, Sung Jae; Kim, Myung Hwan; Kim, Hae Kyoung; Lee, Chul Lyong; Bang, Sung Jo; Park, Wan; Kim, Sung Ho; Joo, Kwang Ro; Lee, Jung Hee; Lee, Sung Koo; Min, Young Il; Gong, Gyoung Yub

Abstract

BACKGROUND/AIMS: The prognosis of extrahepatic bile duct carcinoma is very poor. The value of the gross morphology and location of the tumor in the bile duct as prognostic factors have been contro versial. Thus, we conducted a retrospective analysis of the prognostic factors.
METHODS
During the period between June, 1989 and December, 1996, 193 cases of extrahepatic bile duct carcinomas were selected and 108 cases of them were curatively resected. We collected data at the point of August 1997.
RESULTS
The mean age was 61.9 (17-87) years and the male to temale ratio was 2.5:1. Th frequency of tumor according to the location was 32.1% in the upper part, 31.6% in the middle par and 5.3% in diffuse type. The overall 1,2,3, and 5-year survival rate was 49.9%, 32.2%, 23.4%, and 17.8%, respectively. In the patients with curative surgery (n=108), the 1-, 2-, 3-, and 5- year surviva rate was 70.0%, 48.0%, 37.1% and 27.2%, respectively. In the patients without carative surgery (n=85), the 1-, 2-, 3-, and 5-year survival rate was 24.0%, 12.5%, 7.1%, and 3.0%, respectively. The survival rates of stage I were significantly better than those of stage II, stage III and stage IV-A. Th survival rates of well differentiated histology were significantly better than those of moderate or poo differentiation.
CONCLUSIONS
The stage, histologic differentiation and curative resectability of the extrahepatic bile duct carcinoma were significant prognostic factors. However, the gross morphology and location of the tumor had no prognostic significance.