Miyakawa Shuichi, Ishihara Shin, Horiguchi Akihiko, Takada Tadahiro, Miyazaki Masaru, Nagakawa Takukazu
Department of Biliary and Pancreatic Surgery, Fujita Health University, Toyoake, Aichi, Japan.
J Hepatobiliary Pancreat Surg. 2009;16(1):1-7. doi: 10.1007/s00534-008-0015-0. Epub 2008 Dec 26.
BACKGROUND/PURPOSE: The results from the Japanese Biliary Tract Cancer Statistics Registry from 1988 to 1998 were reported in 2002. In the present study, we report here selectively summarized data as an overview of the 2006 follow-up survey of the registered cases from 1998 to 2004 for information bearing on problems with the treatment of cancer of the biliary tract.
A total of 5,584 patients were registered from 1998 to 2004. The site of cancer was the bile duct in 2,732 patients, the gallbladder in 2,067, and the papilla of Vater in 785. Those cases were analyzed with regard to patient survival according to the extent of tumor invasion (pT), the extent of lymph node metastasis (pN) and the stage.
The five-year survival rate after surgical resection was 33.1% for bile duct cancer, 41.6% for gallbladder cancer, and 52.8% for cancer of the papilla of Vater. For hilar or superior bile duct cancer, the 5-year survival rate was lower with an increase in the pT, pN and f stage, except pT3 vs. pT4, pN1 vs. pN2 and stage III vs. stage IVa. For middle or distal bile duct cancer, the 5-year survival rate was lower with increase in pT, pN and f stage, except pT2 vs. pT3, pN2 vs. pN3, stage II vs. stage III and stage III vs. stage IVa. For gallbladder cancer, the 5-year survival rate was lower with increase in pT, pN and f stage. For cancer of the papilla of Vater, the 5-year survival rate was lower with increase in pT, pN and f stage, except pT1 vs. pT2, pN1 vs. pN2, and stage III vs. stage IVa.
In the present study, the outcomes of surgical treatment were better than that of the previous report from Japan and foreign countries. The pT, pN and stage of gallbladder cancer are well defined. However, there were no significant differences in some groups of those of bile duct cancer and cancer of the papilla of Vater.
背景/目的：日本胆道癌统计登记处1988年至1998年的结果于2002年公布。在本研究中，我们在此报告对1998年至2004年登记病例的2006年随访调查数据进行的选择性总结，以获取有关胆道癌治疗问题的信息。
1998年至2004年共登记了5584例患者。癌症部位为胆管的有2732例，胆囊的有2067例，Vater壶腹的有785例。根据肿瘤浸润范围（pT）、淋巴结转移范围（pN）和分期对这些病例的患者生存率进行了分析。
胆管癌手术切除后的五年生存率为33.1%，胆囊癌为41.6%，Vater壶腹癌为52.8%。对于肝门部或上段胆管癌，除pT3与pT4、pN1与pN2以及III期与IVa期外，随着pT、pN和f分期的增加，5年生存率降低。对于中段或下段胆管癌，除pT2与pT3、pN2与pN3、II期与III期以及III期与IVa期外，随着pT、pN和f分期的增加，5年生存率降低。对于胆囊癌，随着pT、pN和f分期的增加，5年生存率降低。对于Vater壶腹癌，除pT1与pT2、pN1与pN2以及III期与IVa期外，随着pT、pN和f分期的增加，5年生存率降低。
在本研究中，手术治疗的结果优于日本和国外之前的报告。胆囊癌的pT、pN和分期定义明确。然而，胆管癌和Vater壶腹癌的某些组之间没有显著差异。
