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The Role of Postoperative Radiation Therapy in Extrahepatic Bile Duct Cancers  

Kim Woo Chul (Department of Radiation Oncology, Inha University Hospital)
Lee Don Haeng (Department of Gastroenterlogy, Inha University Hospital)
Lee Keon Young (Department of Surgery, Inha University Hospital)
Lee Mi Jo (Department of Radiation Oncology, Inha University Hospital)
Kim Hun Jung (Department of Radiation Oncology, Inha University Hospital)
Lee Suk Ho (Department of Radiation Oncology, Inha University Hospital)
Loh John JK (Department of Radiation Oncology, Inha University Hospital)
Publication Information
Radiation Oncology Journal / v.21, no.2, 2003 , pp. 118-124 More about this Journal
Abstract
Purpose: The goal of this study was to determine the role of postoperative radiation therapy in extrahepatic bile duct cancers. Materials and Methods: Between 1997 and 2001, 41 patients with extrahepatic bile duct cancer having undergone surgical resection were retrospectively analyzed. Of the 41 patients, 22 were treated by surgery alone (Group I) with remaining 19 treated by surgery and postoperative radiation therapy (Group II). A gross total surgical resection with pathologically negative margins was peformed in 11 of the patients (50$\%$) in Group 1, and in 7 of the patients (36.8$\%$) in Group II. There were no significant differences in the disease stage, surgical procedure or pathological characteristics of the two groups. The patients in group II received 45$\~$54 Gy (median: 50.4 Gy) of external beam radiation therapy to the tumor bed and draining nodal area. Results: The local failure rate was significantly higher In group I (54.5$\%$) than in group II (15.8$\%$)(p=0.01). Of the 12 failed patients in Group I and the 3 failed patients in group II, 7 and 3 had a positive resection margin. The overall 3-year survival rates were 38.3 and 38.9$\%$ and the 3-year disease free survival rates were 18.8 and 26.3$\%$ in groups I and II, respectively. However, the patients with positive resection margins who received adjuvant radiation therapy had higher 3-year overall survival rates than those with surgery alone (36.4$\%$ vs. 24.2$\%$, p=0.06), and 3-year disease free survival rate was significantly higher in the group II patients who had positive margins compared with those in group I (25.0$\%$ vs. 18.2$\%$, p=0.04). Conclusion: Postoperative adjuvant radiation therapy appeared to reduce the incidence of local failure in patients with extrahepatic bile duct cancer, and might improve the survival rate in the patients with positive resection margins.
Keywords
Bile duct cancer; Operation; Radiation therapy;
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