Surgical treatment for distal bile duct cancer

Abstract

In 2013, the Japanese 6th edition of the general rules for surgical and pathological studies on cancer of the biliary tract was published, and the lower bile duct cancer and middle bile duct cancer were merged to distal bile duct cancer. The standard operation for distal bile duct cancer was pancreaticoduodenectomy (PD) with lymphadenectomy. In this study, we analyzed the surgical outcomes of distal bile duct cancer to clarify the prognostic factor. From January 2000 to October 2012, 125 patients underwent the surgical resection for distal bile duct cancer in Tohoku University Hospital. Of 125 patients, 107 patients (86%) underwent PD and the others underwent the resection of the bile duct. Overall 5-year survival rate was 40%and median survival time (MST) was 51.9 months. Pathologically positive for lymphonode metastasis, duodenal invasion, and surgical margin were significantly independent worse prognostic factors by the analysis from Cox proportional-hazards model. To improve the outcome of the distal bile duct cancer, the multidisciplinary approach including adjuvant chemo (radio) therapy or neoadjuvant chemo (radio) therapy, will be needed.