Premium
Biliary tract cancer treatment: results from the Biliary Tract Cancer Statistics Registry in Japan
Author(s) -
Nagakawa Takukazu,
Kayahara Masato,
Ikeda Seiyo,
Futakawa Shunji,
Kakita Akira,
Kawarada Hirofumi,
Matsuno Masaki,
Takada Tadahiro,
Takasaki Ken,
Tanimura Hiroshi,
Tashiro Seiki,
Yamaoka Yoshio
Publication year - 2002
Publication title -
journal of hepato‐biliary‐pancreatic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 0944-1166
DOI - 10.1007/s005340200076
Subject(s) - bile duct cancer , gallbladder cancer , major duodenal papilla , medicine , biliary tract , cancer , cancer registry , bile duct , stage (stratigraphy) , gastroenterology , survival rate , ampulla of vater , lymph node , carcinoma , biology , paleontology
Background/Purpose A registry project for cancers of the biliary tract accumulated a total of 11030 cases for 10 years. In the present study, registered cases were analyzed for information bearing on problems with the treatment of cancer of the biliary tract. The Japanese classification of lymph nodes was also considered on the basis of the results of this study. Methods In 11030 cases, the site of cancer was the gallbladder in 4774, the bile duct in 4833, and the papilla of Vater in 1423. Those cases were analyzed with regard to patient survival according to the stage of disease and the extent of lymph node metastasis. Results More than 11000 cases of cancer of the biliary tract have been registered to date from 158 member institutions of the Japanese Society of Biliary Surgery. While the 5‐year survival rates for stage I gallbladder cancer and cancer of the papilla were 77% and 75%, respectively, those for stage I hilar or upper bile duct cancer and middle or lower bile duct cancer were 47% and 54%. For stage II and stage III disease, the 5‐year survival rates were about 50% for gallbladder cancer and 30% or higher for cancer of the papilla, while survival was only 20% to 30% for bile duct cancer, regardless of specific site. For stage IV, the 5‐year survival rate was unexpectedly high, being about 10% or higher for cancers at all sites, with 19% for cancer of the papillary region being the highest. Thus, there still seem to remain surgical indications for stage IV cancers. The lymph node metastasis rate was about 40% for cancers at all sites. Changes in surgical procedures to improve the 5‐year survival rate in patients with n2 metastasis or less will be needed. Noncurative resection occurred frequently for cancers at all sites, particularly in cancers of the hilar or upper bile duct, accounting for 60% of cases or more. We have to recognize that measures to reduce inadvertent noncurative resection are fundamental to the treatment of cancer. Conclusions Considering the survival results according to specific lymph nodes involved, we concluded that the Japanese classification of lymph nodes, particularly hepatoduodenal ligament lymph nodes, should be reexamined, while another procedure to remove such lymph nodes completely should be developed.