OBJECTIVETo study prognostic factors after surgical procedure for distal bile duct cancer.

METHODSA retrospective clinical analysis was made in 173 cases of distal bile duct cancer, admitted to our hospital from February 1996 to December 2002. Fourteen clinicopathologic factors that could possibly influence survival were selected. A multivariate analysis of these individuals was performed using the Cox Proportional Hazards Model.

RESULTSThere were 99 males and 74 females. The age ranged from 27 to 74 years old with a mean of 55.5. Radical resection was performed on 152 cases with radical resection rate of 87.9%. 29 cases died of liver metastasis with a rate of 46.8% in total death cases. The statistical analysis showed that surgical procedure, lymph node metastasis and pathological differentiation grade affected postoperative survival significantly, but transfusion, invasion of pancreas, postoperative radiotherapy and chemotherapy, ERCP, diameter of tumour, serum level of CA-19-9, preoperative total serum bilirubin level (TBIL), ratio of albumin to globulin (A/G), sex and age are not significant factors influencing postoperative survival.

CONCLUSIONSRadical resection is only curative treatment modality. Aggressive treatment and prevention on postoperative liver metastasis is a important strategy to improve the survival for distal bile duct cancer.