Abstract
Sixty-seven patients with lower bile duct carcinoma underwent surgical resection in our depart-Of these patients,10 survived for more than 5 years (long-term survivors), while 29 died of recurrent tumor within 5 postoperative years (non-long-term survivors). We compared histological prognostic factors of these patients between the two groups. In the long-term survivors, the depth of wall invasion was mostly ss or less, and the macroscopic type was frequently the localized type. No significant difference was observed in the histological type. Lymph node metastasis was n1 or less in all long-term survivors but was n2 or n3 in many non-long-term survivors. Vascular or nerve invasion was not observed or, if present, was mild in long-term survivors, but it was advanced in many non-long-term survivors. Histological pancreatic invasion was panc1a or less in more than half the long-term survivors but panc1b or above in most ofthe non-long-term survivors. As for histological invasion, em factor was em0 in all long-term survivors and was significantly different compared with the non-long-term survivors, but no significant difference was observed in hm factor. The comprehensive stage was I or II in many long-term survivors but was III or above in most of the non-long-term survivors. The comprehensive curability was curA or B in the long-term survivors but was often curC in the non-long-term survivors. To obtain a good long-term postoperative survival rate, surgical treatment should be indicated for tumors below stage II without vascular or nerve invasion. Even when vascular and nerve invasion is observed, they should be mild. However, the most important issue for obtaining a good long-term survival rate is to achieve above curB level of curability by radical resection of tumor.
