Analysis of clinical therapeutic efficiency in 87 patients with extrahepatic bile duct cancer
Objective: To analyze the clinical characteristics, surgical efficacy and prognostic factors of extrahepatic cholangiocarcinoma in different locations. Methods: The clinical data of 87 patients with cholangiocarcinoma treated from May 2004 to April 2014 were retrospectively analyzed. Results: Of the 87 patients, 58 cases had hilar cholangiocarcinma and 29 cases had distal extrahepatic cholangiocarcinoma, and jaundice was the major symptom among them; 56 cases underwent radical resection, that included 33 cases (56.9%, 33/58) of hilar cholangiocarcinoma and 23 cases (79.3%, 23/29) of distal extrahepatic cholangiocarcinoma, while the remaining cases received either palliative treatment for remission of jaundice or no treatment. In patients with hilar cholangiocarcinoma, the 1-, 2- and 3-year survival rate after radical surgery was 62.2%, 35.1% and 27.0% respectively, the AJCC stage and lymph node metastasis were independent factors affecting overall survival time, and AJCC stage, lymph node metastasis and liver invasion were independent factors affecting the tumor-free survival time (all P<0.05). In those with distal extrahepatic cholangiocarcinoma, the 1-, 2- and 3-year survival rate after radical surgery was 91.6%, 54.2% and 37.5% respectively, and AJCC stage was the only independent factor affecting either overall survival time or tumor-free survival time (both P<0.05). Between patients with hilar cholangiocarcinoma and distal extrahepatic cholangiocarcinoma, the median overall survival time in the whole group, the median overall survival time and tumor-free survival time in those undergoing radical resection, and the median overall survival time in those without radical treatment showed no significant difference (all P>0.05). Conclusion: For extrahepatic bile duct cancer in different locations, radical resection is the common effective treatment method, and AJCC staging system is effective for estimating the prognosis.