Long-term survival in carcinoma of the biliary tract. Analysis of prognostic factors in 146 resections.

In 146 consecutive patients undergoing resection for carcinoma of the biliary tract, various tumor characteristics that affected long-term survival of the patients were studied. Patients with gallbladder carcinoma whose tumors had no serosal infiltration or vessel invasion were grossly papillary, or were papillary or well-differentiated adenocarcinoma histologically survived longer than those without these tumor characteristics. In upper-third lesions, patients whose tumors showed no serosal infiltration or vessel invasion, were grossly papillary, were papillary or well-differentiated adenocarcinoma histologically, or were treated with hepatic lobectomy had a higher chance of long-term survival. Patients with the middle-third lesions, whose tumors were grossly papillary or nodular or whose margins were tumor-free, were apt to survive longer. Long-term survival for patients with lower-third lesions was obtained most often in patients without lymph node metastasis or vessel invasion.