Clinicopathological Studies of Central Type of Cholangiocarcinoma Compared with Hilar Bile Duct Cancer

Hiroyuki Makino, Teruhisa Sonoyama, Hisakazu Yamagishi, Takahiro Oka, Kazuyo Naito*, Yoshihiro Ohmori*, Takeshi Hironaka**

The Second Department of Surgery, Kyoto Prefectural University of Medicine
*Department of Surgery, Kyoto Prefectural Yosanoumi Hospital **Kohoku General Hospital

Ten patients with central type of cholangiocarcinoma and 13 patients with hilar bile duct cancer underwent hepatic resection at our institution during the past 12 years. In this study, differences in the clinicopathological features and modes of spread of carcinoma between these two types of carcinomas were investigated. The gross appearance of these two carcinomas was different; cholangiocarcinomas formed tumor nodules extending in the liver parenchyma, whereas hilar bile duct cancers often showed infiltrative growth along the bile ducts. The mean tumor volume of cholangiocarcinoma was significantly larger than that of hilar bile duct cancer. Invasion to the portal vein or hepatic artery was found in half of both groups, but invasion to adjacent sites such as stomach, duodenum, colon and diaphragm was more frequent in cholangiocarcinomas. Metastases to the lymph nodes (No. 12, 13, 8), and lymphatic, vascular and perineural invasion were frequently found in both types. The incidence of a positive surgical margin at the intrahepatic bile duct was higher in hilar bile duct cancer than in cholangiocarcinoma. Patients with hilar bile duct cancer who underwent resection had a relatively better prognosis, with a 5-year survival rate of 62.5%. Most of the patients with cholangiocarcinoma were in the advanced stages, resulting in the wide spread of carcinoma and a poor prognosis with a 3-year survival rate of 17.9%. Thus, these two types of carcinomas had differences in modes of spread and prognosis, although they showed some similar clinicopathological features.

Key words
carcinoma of the biliary tracts, central type of cholangiocarcinoma, hilar bile duct cancer, modes of spread of carcinoma

Reprint requests
Hiroyuki Makino Department of Surgery, Kyoto First Red Cross Hospital
15-749 Honamchi, Higashiyamaku, Kyoto, 605 JAPAN

Accepted
January 11, 1995

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