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Adenocarcinoma of the distal bile duct. A clinicopathologic outcome analysis after curative resection.

AbstractBACKGROUND/AIMS:
Primary distal bile duct adenocarcinomas (DBDAs) are unusual neoplasms, necessitating pancreaticoduodenectomy for cure. The aims of this study were to evaluate the prognostic importance of lymphatic and perineural invasion, long-term outcome of patients after resection, and differences in outcome with hilar cholangiocarcinoma and pancreatic carcinoma.
METHODS:
The medical records and histopathological slides of 15 patients (8 men and 7 women) with documented DBDA after curative pancreaticoduodenectomy were reviewed.
RESULTS:
Nine standard and 6 pylorus-preserving pancreaticoduodenectomies were performed. TNM staging included 1, 3, 2, 8, and 1 patient in stages I, II, III, and IVA and IVB, respectively. Lymphatic and perineural invasion was present in 4 (27%) and 9 (60%) patients, respectively. With multivariate analysis only serum bilirubin was a significant prognostic factor. Median survival was 21 months, and 2- and 5-year actuarial survivals were 40 and 20%, respectively. Median survival with adjuvant therapy (n = 6) was 21 months, with 5-year survival of 33%. Five-year actuarial survivals when lymphatic or perineural invasion was present were 0 and 11%, respectively.
CONCLUSION:
DBDA is aggressive, but entails a better prognosis than pancreatic ductal or more proximal bile duct carcinoma. Lymphatic and/or perineural invasion worsen survival.
AuthorsL Bortolasi, L J Burgart, G G Tsiotos, E Luque-De León, M G Sarr
JournalDigestive surgery (Dig Surg) Vol. 17 Issue 1 Pg. 36-41 ( 2000) ISSN: 0253-4886 [Print] Switzerland
PMID10720830 (Publication Type: Journal Article)
CopyrightCopyright 2000 S. Karger AG, Basel
Chemical References
  • Bilirubin
Topics
  • Aged
  • Bilirubin (blood)
  • Cholangiocarcinoma (pathology, surgery)
  • Common Bile Duct Neoplasms (pathology, surgery)
  • Female
  • Humans
  • Lymphatic Metastasis
  • Male
  • Multivariate Analysis
  • Neoplasm Invasiveness
  • Pancreaticoduodenectomy
  • Prognosis
  • Survival Rate
  • Time Factors
  • Treatment Outcome

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