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

Luca Bortolasi, Lawrence J. Burgart, Gregory G. Tsiotos, Enrique Luque-de León, Michael G. Sarr

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

Background/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. Copyright (C) 2000 S. Karger AG, Basel.

Original languageEnglish (US)
Pages (from-to)36-41
Number of pages6
JournalDigestive Surgery
Volume17
Issue number1
StatePublished - 2000

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Bile Ducts
Adenocarcinoma
Pancreaticoduodenectomy
Survival
Klatskin Tumor
Neoplasm Staging
Pylorus
Bilirubin
Medical Records
Multivariate Analysis
Carcinoma
Serum
Neoplasms

Keywords

  • Bile duct cancer
  • Cholangiocarcinoma
  • Pancreaticoduodenectomy
  • Periampullary carcinoma

ASJC Scopus subject areas

  • Surgery

Cite this

Bortolasi, L., Burgart, L. J., Tsiotos, G. G., Luque-de León, E., & Sarr, M. G. (2000). Adenocarcinoma of the distal bile duct. A clinicopathologic outcome analysis after curative resection. Digestive Surgery, 17(1), 36-41.

Adenocarcinoma of the distal bile duct. A clinicopathologic outcome analysis after curative resection. / Bortolasi, Luca; Burgart, Lawrence J.; Tsiotos, Gregory G.; Luque-de León, Enrique; Sarr, Michael G.

In: Digestive Surgery, Vol. 17, No. 1, 2000, p. 36-41.

Research output: Contribution to journalArticle

Bortolasi, L, Burgart, LJ, Tsiotos, GG, Luque-de León, E & Sarr, MG 2000, 'Adenocarcinoma of the distal bile duct. A clinicopathologic outcome analysis after curative resection', Digestive Surgery, vol. 17, no. 1, pp. 36-41.
Bortolasi L, Burgart LJ, Tsiotos GG, Luque-de León E, Sarr MG. Adenocarcinoma of the distal bile duct. A clinicopathologic outcome analysis after curative resection. Digestive Surgery. 2000;17(1):36-41.
Bortolasi, Luca ; Burgart, Lawrence J. ; Tsiotos, Gregory G. ; Luque-de León, Enrique ; Sarr, Michael G. / Adenocarcinoma of the distal bile duct. A clinicopathologic outcome analysis after curative resection. In: Digestive Surgery. 2000 ; Vol. 17, No. 1. pp. 36-41.
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abstract = "Background/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. Copyright (C) 2000 S. Karger AG, Basel.",
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