Different clinical characteristics in biliary tract cancers

Abstract

4215 Background: Biliary tract cancer (BTC) includes intrahepatic cholangiocarcinoma, Klastkin tumor, extrahepatic cholangiocarcinoma, gall bladder cancer and ampulla of Vater cancer. These cancers are usually not common, and classified as resistant cancer. In many clinical trials, all type of BTC is approached with same protocol, although each cancer has different response to anti-cancer treatment. In the present study, we evaluated clinical course and characteristics of BTC after potentially curative resection to know the differences between BTC. Methods: Between October 1994 and December 2003 in Kangnam St. Mary’s hospital, patients, who underwent potentially curative resection with BTC, were enrolled. We reviewed the patients’ clinical record and analyzed clinical characteristics. We classified the recurrence pattern as 3 type, recurrence at anastomosis site, liver and biliary tract recurrence, and distant other organ metastasis. Results: Of total 177 patients, male was 110, and female was 67. Gall bladder cancer (54, 30.5%) is most common, and the next is extrahepatic cholangiocarcinoma (45, 24.5%). Except gall bladder cancer, male was more common than female. Median age was 61(58–62), and no difference found between each cancer of BTC. After surgery, 53(30%) patients took adjuvant treatment, using 5-FU-based chemotherapy or radiotherapy. There is no significant difference in recurrence rate, but recurrence pattern is different according to cancer type (p=0.028). Gall bladder cancer and ampulla of Vater cancer had recurrence in distant organ and liver metastasis more than local recurrence. There is no difference in pathological characteristics. Conclusions: In BTC, gall bladder cancer is most common. In aspect of clinical findings, no statistically significance found except recurrence pattern. After potentially curative resection, recurrence pattern is different according to each type of cancer. These results suggest that different approach to adjuvant treatment modality may be established for BTC. We are ongoing to perform protein expression to determine special characteristics of each cancer. No significant financial relationships to disclose.