2007 Volume 54 Issue 1+2 Pages 41-49
Of the patients who underwent resection of hilar cholangiocarcinoma, those who received palliative surgery, or could not be followed up clinicopathologically, were excluded from this study. In the remaining 37 patients, the cumulative postoperative survival rate (simply referred to as the cumulative survival rate below) was analyzed according to gross types, histopathological parameters, final stages, and final curability. These patients showed a 5-year survival rate of 17.7% and a 50% survival of 2.2 years. By gross type, patients with a localized papillary or nodular expansion type tended to have a better survival rate than those with an invasive papillary or nodular expansion type. A greater histological depth of invasion tended to be associated with a poorer prognosis: the s(−) group, that is, a group of patients without serosal exposure of cancer (invasion depths of m, fm, and ss) had a significantly better prognosis than the s(+) group, a group of patients with serosal exposure of cancer (invasion depths of se and si). Other histopathological parameters, such as ly, pn, pHinf, pHM, and pEM, were associated with significant prognostic differences. By final stage, the stage I/II group and stage III or higher group showed a particularly significant difference in prognosis. By final curability, the curability A/B group had a significantly better prognosis than the curability C group. Taken together, surgery providing curability A and B promises a good long-term prognosis. Therefore, it is important that efforts are made to detect cancer early, adequately evaluate the degree of cancer extension, and determine the extent of resection and the surgical technique.
