Clinical Presentation, Diagnosis and Survival of Resected Distal Bile Duct Cancer
1998; Karger Publishers; Volume: 15; Issue: 5 Linguagem: Inglês
10.1159/000018654
ISSN1421-9883
AutoresAlessandro Zerbi, Gianpaolo Balzano, Biagio Eugenio Leone, Enzo Angeli, Paolo Veronesi, Valerio Di Carlo,
Tópico(s)Gallbladder and Bile Duct Disorders
ResumoThe aim of the study was the definition of the clinical features and survival of 27 resected cases of distal bile duct carcinoma. This neoplasm accounted for 14% of all periampullary malignancies treated by pancreaticoduodenectomy between 1990 and 1996. Jaundice was present in 96% of patients, but was the first symptom only in 78%. Preoperative investigations allowed to recognize distal bile duct cancer in a minority of patients (41%). Operative mortality and morbidity were 3.7 and 44%, respectively. Most patients (88%) were assigned to UICC stage IV-A. Postoperative survival was not significantly better than survival of 101 patients undergoing pancreaticoduodenectomy for pancreatic ductal carcinoma; median survival was 22 months, with a 13% 5-year survival rate. Determinants of a better prognosis were UICC stage <IV-A (p = 0.05) and absence of lymphatic invasion (p < 0.01); prognostic significance of nodal involvement, tumor grading, perineural invasion, tumor size, pylorus preservation and adjuvant therapies could not be proven. Lymphatic invasion was the strongest determinant of survival on multivariate analysis (p < 0.01).
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