The long-term survival of patients with carcinoma of the main hepatic duct junction.

Carcinoma of the main hepatic duct junction tends to invade extensively the bile ducts and hepatic parenchyma, although dissemination is rarely seen. Therefore, extensive resection of the bile ducts combined with hepatic resection is the procedure of choice for treating this disease. From January 1973 to January 1987, 23 of 41 patients underwent resection, giving a resectability rate of 56%. One patient died postoperatively, yielding an operative mortality rate of 4.3%. The 5-year actuarial survival rate is 29.8%. Three patients are now alive and well 6 years and 9 months, 5 years and 10 months, and 5 years and 5 months after the operation. One additional patient who underwent resection in an affiliated hospital has done well for 8 years and 8 months. The results from these four patients treated by curative resection support a strategy featuring curative resection with aggressive surgery.