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The experiences of hilar skeletonization for the treatment of locally advanced proximal bile duct cancer.

Authors
Kim, MW; Kim, WH; Wang, HJ; Chung, JB; Chun, M
Citation
Hepato-gastroenterology, 48(41):1298-1301, 2001
Journal Title
Hepato-gastroenterology
ISSN
0172-6390
Abstract
BACKGROUND/AIMS: Because proximal bile duct cancer easily involves the surrounding tissue, tumor cells often remain after apparent macroscopically complete radical resection. We evaluated the effect of resective modality of these tumors on prognosis and the effect of postoperative radiotherapy on survival of patients with microscopic residual tumor following local resection in locally advanced proximal bile duct cancer.



METHODOLOGY: From November, 1990 to October, 1993, 45 proximal bile duct cancer patients who received local excision were entered onto this prospective, nonrandomized study. The patients were divided into three groups after operation, 16 patients with curative resection; 15 noncurative resection; and 14 nonresection. Patients who had positive lymph nodes or microscopic cancer cells in resection margin or adjacent major vessels, were treated with postoperative external radiotherapy, 5040 cGy for 40 days.



RESULTS: The overall 1-, 2-, and 5-year survival of the patients was 62.2%, 24.4%, and 15.6%, respectively. The overall mean and median survival of patients was 24.1 +/- 3.98 (mean +/- SE) months and 13 +/- 0.74 months, respectively. Survival rates between resection and nonresection showed a statistically significant difference (P 0.05).



CONCLUSIONS: The resection is the treatment of choice for locally advanced proximal bile duct cancer, if resectable and the noncurative resection followed by postoperative external radiotherapy may be beneficial to the patients with locally advanced proximal bile duct cancer.
MeSH terms
AdolescentAdultAgedBile Duct Neoplasms/mortalityBile Duct Neoplasms/pathologyBile Duct Neoplasms/radiotherapyBile Duct Neoplasms/surgery*Bile Ducts, Extrahepatic/pathologyBile Ducts, Extrahepatic/radiation effectsBile Ducts, Extrahepatic/surgery*Combined Modality TherapyFemaleHumansLymphatic MetastasisMaleMiddle AgedNeoplasm InvasivenessNeoplasm StagingPalliative CarePrognosisProspective StudiesRadiotherapy, AdjuvantSurvival Rate
PMID
11677950
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Radiation Oncology
Journal Papers > School of Medicine / Graduate School of Medicine > Surgery
AJOU Authors
김, 명욱김, 욱환왕, 희정전, 미선
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