Curative resection and good quality of life in patients with biliary tract cancer

Abstract

Margin-negative (R0) resection of liver and/or pancreas with combined vascular resection has contributed to the evolution of treatment of biliary tract cancers. However, aggressive hepatic resection or pancreatic resection impairs patients' quality of life (QOL). Thus, both R0 resection and QOL are important factors in the treatment.

Four hundred and seventy-seven consecutive patients with biliary tract cancers; intrahepatic cholangiocarcinoma (n=77), perihilar cholangiocarcinoma (n=65), distal cholangiocarcinoma (n=126), gall-bladder carcinoma (n=112), and ampullary carcinoma (n=97) who underwent surgical resection at the Tokai University Hospital between 2000 and 2020 were retrospectively analyzed.

The 5-year survival rate for patients with intrahepatic cholangiocarcinoma, perihilar cholangiocarcinoma, distal cholangiocarcinoma, gall-bladder carcinoma, and ampullary carcinoma after R0 resection were 55%, 46%, 60%, 63%, 64%, respectively. The 5-year survival rate for patients with those carcinomas after R1 resection were 22%, 10%, 16%, 6%, 0%, respectively. There was a significant difference in survival between patients after R0 resection and those after R1 resection. Eight patients (1.7%) postoperatively died in hospital. In conclusion, better survival results could be achieved by R0 resection in patients with biliary tract cancers.