Long-term survival and prognostic factors in the surgical treatment of mass-forming type cholangiocarcinoma

Background Mass-forming type cholangiocarcinoma is a distinct form of chola ngiocellular carcinoma, with pathologic and biologic behavior different fro m those of other types. The clinical consequences of these differences have never been clarified. Methods. Fifty-two consecutive patients (32 men and 20 women, mean age 62 y ears) with mass-forming type cholangiocarcinoma that had been treated with curative surgical resection between 1980 and 1998 were retrospectively eval uated. Long-term survival and disease-free survival were calculated, and un ivariate and multivariate analysis of various prognostic factors was conduc ted. Results. The 30-day postoperative mortality rate was 2 %, and the overall a nd disease-free 5-year survival rates were 36% and 34 %, respectively. Univ ariate analysis identified 5 significant risk factors for overall survival: surgical margin, lymph node metastasis, lymph node dissection, vascular in vasion, and left-side location of the main tumor Two risk factors were iden tified for disease-free survival: surgical margin and lymph node metastasis . Multivariate analysis confirmed that surgical margin, lymph node metastas is, and vascular invasion were independently significant variables for over all survival. Conclusions This is the first reported study on the effectiveness of liver resection for the treatment of mass-forming type cholangiocarcinoma, showin g that surgical therapy can prolong survival if local radicality can be ach ieved and lymph-node metastases are absent.