Impact of External Beam Radiotherapy after Surgical Resection for Hilar Bile Duct Carcinoma

Kim, Ki Hoon; Choi, Chang Soo; Choi, Young Kil; Paik, Nak Hwan

Abstract

PURPOSE
For bile duct carcinomas, local treatment including surgical resection plays an important role. In the case of hilar bile duct carcinoma, the rate of resection is low and local recurrences are frequent, even after radical resection. Radiotherapy, one of the local remedies, may influence the treatment result. The aims of this study were to determine the effect of radiotherapy after surgical resection on the length of survival, as well as the radiation toxicity, in patients with hilar bile duct carcinoma. METHODS: Seventy patients with hilar bile duct carcinoma were included in this study; 46 underwent surgical resection only while 24 additionally received external beam radiotherapy after resection. The authors compared the survival rate between the two groups and investigated the complications following radiotherapy. RESULTS: The overall 5-year survival rate after surgical resection was 28.3%; 20.1% and 31.3% in patients with and without radiotherapy, respectively. The difference was not significant (P> 0.10). In patients with positive surgical margin, the 5-year survival rate for the radiation group was superior to that of the non-radiation group (21.8% vs. 10.1%), but aqain the difference was not statistically significant (P> 0.10). In patients with lymph node metastasis the survival rates for radiation and non-radiation groups showed no significant difference(median survival, 7 vs. 13 months) (P> 0.10). Leukopenia (n=2) and digestive complications including gastroduodenal ulcers (n=2) occurred after radiotherapy. CONCLUSION: External beam radiotherapy after radical resection had no significant effect on the length of survival in patients with resectable hilar bile duct carcinomas.