Clinicopathological features of long-term survivors for advanced biliary tract cancer and impact of the number of lymph nodes involved

Background & aimTo investigate the characteristics of long-term survivors after surgery for advanced biliary tract cancer (BTC), especially those with local invasion and/or lymph node involvement.MethodsWe analyzed the features of long-term survivors using a prospectively collected database and verified the results using recent patients' data which have been well-described, especially in relation to lymph node dissection and metastasis. We used classification by the Japanese Society of Biliary Surgery (JSBS).ResultsAmong 170 patients with advanced BTC (Stage III or IV in JSBS), 25 (10 bile duct cancer, 9 gall bladder cancer, and 6 cancer of the papilla of Vater) survived for more than 5 years. Twenty-four patients had undergone fCurA/B (R0) surgery in these 25 patients. In comparison with the patients who did not survive for 5 years, the long-term survivors had fewer metastatic lymph nodes, that is, up to three (p = 0.0028). In regard to the impact of lymph node metastasis, the prognostic factor was the number of lymph nodes (3-year overall survival, 0 or 1: 68.1% vs >2: 40.0%, p = 0.0304).ConclusionFor obtaining long-term survival, curative resection would be necessary in patients with no more than one lymph node metastasis.