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Chonnam Med J. 1996 Jun;32(1):69-77. Korean. Original Article.
Park CH , Kim GT , Paek KW , Park YU , Kim SM , Kim HS , Koo C , Choi SK , Rew JS , Yoon CM .
Department of Internal Medicine, Chonnam National University Medical School, Kwangju, Korea.

Bile duct cancer was known to have extremely poor prognosis because of the delayed diagnosis and rare curative resection. However recent studied reported that the development of diagnostic tools and use of palliative percutaneous transhepatic billary drainage procedure (PTBD) improved the survival rate and prognosis. To evaluate the prognostic significance of therapeutic modalities in the bile duct cancer, the clinical characteristics, survival time, and survival rate were compared according to the therapeutic modalities. The clinical records of 83 patients with bile duct cancer diagnosed clinically from January 1991 to December 1994 reviewed. We divided the 83 patients with bile duct cancer into 3 different groups according to the therapeutic modalities; Group A; surgical treatment group, Group B; PTBD group, Group C; no treatment group. Statistical analysis of the clinical characteristics were performed by Chi-square method and ANOVA test, and survival rate was calculated by Kaplan-Meier method. The results were as follws: 1) There was no significant difference in age, sex, lesion site, existance of metastasis, duration of symptoms, hemoglobin, alkaline phosphatase, gamma-GTP, blood urea nitrogen, creatinine, prothrombin time, white blood cell count, and platelet count among 3 groups. 2) Median survival time was 12 months in 83 patients. Median survival times in group A, B and C were 21 months, and 3 month retrospectively. 3) Overall 1 year survival rate was 44.7% in 83 patients, And 1 year survival rates in group A, B and C were 68%, 44.9%, and 0% retrospectively. Overall 2 year survival rate was 22.1% in 83 patients. And 2 year survival rates in Group A and B were 45.3%, 17.3%. There was significant difference among group in survival curves (p<0.05). From these results, it is shown that surgical treatment offered the best prognosis and the drainage procedure increased the survival rate than no treatment group. Therefore, to improve the overall prognosis, early diagnosis and curative resection should be done, and the next recommendable method will be the drainage procedure.

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