A Clinicopathological Study on Surgical Cases with Bile Duct Cancer in Middle and Distal Portions

Kazuhisa Yabushita, Kohji Konishi, Masahiko Tsuji, Fumiyoshi Saitoh, Hiroyuki Sahara, Wataru Fukushima, Naotaka Kadoya, Takao Taniya, Yoshitaka Kuroda, Atsuo Miwa*

Department of Surgery, Toyama Prefectural Central Hospital
*Department of Clinical Pathology, Toyama Prefectural Central Hospital

Clinicopathological findings and outcome of 49 surgical cases of bile duct cancer in the middle (Bm) and distal (Bi) portions over a 16 year period were studied. The rate of resection was 91.8%. The5-year survival rate was 31.2% and there were seven 5 year survivors (long term survivors). According to stage, Stage III, IV was in the majority and the survival rates decreased with advance in the stage. The rate of liver metastasis was 8.2%, peritoneal dissemination 4.1% and lymph node metastasis (n) 37.8%. The survival rate for patients with lymph node metastasis was significantly lower than for those without it. In both Bm and Bi cancers, invasion to the pancreas (panc) and duodenum (d) were frequently found, but the presence of invasion caused no difference in outcome. In pathological findings, lymphatic invasion (ly) and perineural invasion (pn) were frequently found. The outcome for patients without lymphatic and perineural invasion was better than for those with invasion. With special references to prognostic factors from the viewpoint of long term survivors, n, ly, and pn factors were important. Panc, d factors were not considered prognostic factor. We must reconsider the classification of stages in the general rules for clinical and pathological studies.

Key words
bile duct cancer in middle and distal portions, long term survivor of bile duct cancer, prognostic factor of bile duct cancer

Reprint requests
Kazuhisa Yabushita Department of Surgery, Toyama Prefectural Central Hospital
2-2-78 Nishinagae, Toyama, 930 JAPAN

Accepted
July 6, 1992

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