Abstract：
:The well-known poor prognosis of proximal bile duct cancer is due to its unfortunate anatomical location and its late diagnosis. Successful tumor resection, which is considered to be optimal treatment, depends on many factors. Eighty-eight patients suffering from proximal bile duct cancer underwent surgical exploration at our institution between 1977 and 1998. In 37 patients the tumor was resectable; in the remaining 51 patients exploratory laparotomy or a palliative operation was performed. The median survival after tumor resection was 18.6 months, but median survival after a palliative procedure or an exploratory laparotomy was only 3.4 months (p < 0.001). A curative R0 resection was possible in 11 patients, an R1 resection was performed in 22 patients, and 4 patients had an R2 resection. The median survival rate after R0 resection was 83.6 months, 12.3 months after R1 resection, and 2.7 months after R2 resection (p < 0.001). Survival after resection in patients with negative lymph nodes (n = 30) was significantly longer than in those with positive lymph nodes (n = 7) (p = 0.022). Grade of tumor sclerosis tended to have an influence on resectability rate (p = 0.076). The pattern of tumor growth was without statistical influence. Multivariate analysis revealed resection (p < 0.001) as the only significant prognostic marker for patient survival. Radical resection is the only therapy that provides a chance for long-term survival, with sclerosis of the cancer tending to have an influence on univariate analysis.
journal_name
World J Surgjournal_title
World journal of surgeryauthors
Puhalla H,Gruenberger T,Pokorny H,Soliman T,Wrba F,Sponer U,Winkler T,Ploner M,Raderer M,Steininger R,Mühlbacher F,Laengle Fdoi
10.1007/s00268-003-6656-xkeywords:
subject
Has Abstractpub_date
2003-06-01 00:00:00pages
680-4issue
6eissn
0364-2313issn
1432-2323journal_volume
27pub_type
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pub_type： 历史文章,杂志文章
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