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The survival outcome and prognostic factors for middle and distal bile duct cancer following surgical resection

Authors
 SAE BYEOL CHOI  ;  SEUNG WOO PARK  ;  KYUNG SIK KIM  ;  JIN SUB CHOI  ;  WOO JUNG LEE 
Citation
 JOURNAL OF SURGICAL ONCOLOGY, Vol.99(6) : 335-342, 2009 
Journal Title
 JOURNAL OF SURGICAL ONCOLOGY 
ISSN
 0022-4790 
Issue Date
2009
MeSH
vAged ; Bile Duct Neoplasms/blood ; Bile Duct Neoplasms/mortality ; Bile Duct Neoplasms/pathology* ; Bile Duct Neoplasms/surgery* ; Bilirubin/blood* ; Biomarkers, Tumor/blood* ; Disease-Free Survival ; Duodenal Neoplasms/secondary ; Female ; Humans ; Lymph Nodes/pathology* ; Lymphatic Metastasis ; Male ; Middle Aged ; Multivariate Analysis ; Neoplasm Invasiveness ; Neoplasm Recurrence, Local/diagnosis ; Neoplasm Staging ; Pancreatic Neoplasms/secondary ; Predictive Value of Tests ; Prognosis ; Survival Analysis
Keywords
bile duct cancer ; lymph node metastasis ; R0 resection ; prognosis
Abstract
BACKGROUND AND OBJECTIVES: The objective of this study was to analyze the survival outcome and the clinicopathological factors that influence survival and recurrence of middle and distal bile duct cancer after surgical resection. METHODS: From January 2000 to June 2007, 125 patients underwent surgical resection for middle and distal bile duct cancer. The clinicopathological characteristics and survival outcomes were reviewed retrospectively. RESULTS: Of the 125 patients, 31 patients underwent segmental resection of the bile duct, and 94 patients underwent pancreaticoduodenectomy (PD). Overall survival rates were 85.8% at 1 year and 38.3% at 5 years. Lymph node metastasis, noncurative resection, poorly differentiated tumor, and preoperative bilirubin level greater than 5.0 mg/dl were significant independent predictors of poor prognosis by multivariate analysis. The number of metastatic lymph nodes did not significantly affect survival. Recurrence occurred in 72 patients (61.0%). Disease-free survival rates were 74.1% at 1 year and 42.0% at 3 years. Lymph node and distant metastases and poorly differentiated tumors were found to be significant independent predictors of recurrence by multivariate analysis. CONCLUSIONS: R0 resection confers a survival benefit, thus the surgeon should make an effort to achieve R0 resection. The presence of lymph node metastasis was a significant prognostic factor.
Full Text
http://onlinelibrary.wiley.com/doi/10.1002/jso.21238/abstract
DOI
10.1002/jso.21238
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Kyung Sik(김경식) ORCID logo https://orcid.org/0000-0001-9498-284X
Park, Seung Woo(박승우) ORCID logo https://orcid.org/0000-0001-8230-964X
Lee, Woo Jung(이우정) ORCID logo https://orcid.org/0000-0001-9273-261X
Choi, Sae Byeol(최새별)
Choi, Jin Sub(최진섭)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/103800
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