Carcinoma of the extrahepatic biliary system: Correlation of clinical, pathological, histological and DNA-cytometric parameters with prognosis

Background: Studies concerning the prognosis of all carcinomas of the extra hepatic biliary system together (EBC) do not exist, so far. A detailed and valid histopathological grading-system is lacking and the prognostic releva nce of DNA-cytometric parameters is not clear. Methods: 81 patients with EB C underwent surgical treatment. Clinical, pathological, histomorphological and DNA-cytometric parameters were evaluated. The influence on prognosis wa s tested in univariate and multivariate analysis. Results: Apart from signi ficant perioperative mortality (17%) survival was markedly dependent on the presence of tumor remnants in resection margins. After incomplete and comp lete resection, the median survival was 5 and 19 months, respectively (p < 0.0001). Further parameters with significant prognostic relevance were tumo r localization pTNM-stage, period of complaints, presence of gallstones, hi stological type and DNA-index. Multivariate analysis however demonstrated o nly two independent prognostic factors: status of resection margins and tum or localization. Conclusions: Histomorphological- and DNA-cytometric parame ters failed to demonstrate an additional significant influence on the progn osis in EBCs. Apart from perioperative mortality the survival of patients w ith EBC predominantly depends on tumor localization and the status of resec tion margins.