Primary cancers of extrahepatic biliary passages

B. Mittal*, M. Deutsch, S. Iwatsuki

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

76 Scopus citations

Abstract

We analyzed the records of 22 patients with cancers of extrahepatic biliary passages (EHBP) to understand their natural histories and patterns of failure and to evaluate the effectiveness of various treatments. None of the preoperative investigations consistently defined the entire extent of tumor. Percutaneous transhepatic cholangiography (PTHC) was the most helpful (100%) in accurately defining the site of ductal obstruction. Computed tomography was helpful in diagnosing liver metastases in 53% and primary tumor mass in 23% of patients. The most common sites of tumor failure or persistence were: liver (67%), tumor bed (56%), peritoneum (22%), porta hepatis and lymph nodes (17%). The median survival for the entire group was 6.8 months. Surgery plays an important role in managing these tumors and in defining tumor extent for subsequent adjuvant irradiation. Patients receiving radiation doses ≥ 70 TDF had a longer median survival (11 months) than patients receiving <70 TDF (4.4 months). All three patients, who were alive and free of disease >1 year, received radiation doses ≥ 70 TDF. From our data, it is difficult to comment on the effectiveness of chemotherapy. We have made suggestions regarding radiation volume and doses to various structures. The need for entering these patients into multi-institutional clinical trials is stressed.

Original languageEnglish (US)
Pages (from-to)849-854
Number of pages6
JournalInternational Journal of Radiation Oncology, Biology, Physics
Volume11
Issue number4
DOIs
StatePublished - Apr 1985

Keywords

  • Extrahepatic biliary cancers
  • Patterns of failure
  • Radiotherapy
  • Surgery

ASJC Scopus subject areas

  • Radiation
  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

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