The Experts below are selected from a list of 6543 Experts worldwide ranked by ideXlab platform
Masatoshi Makuuchi - One of the best experts on this subject based on the ideXlab platform.
-
Current surgical treatment for Bile Duct Cancer.
World journal of gastroenterology, 2007Co-Authors: Yasuji Seyama, Masatoshi MakuuchiAbstract:Since extrahepatic Bile Duct Cancer is difficult to diagnose and to cure, a safe and radical surgical strategy is needed. In this review, the modes of infiltration and spread of extrahepatic Bile Duct Cancer and surgical strategy are discussed. Extended hemihepatectomy, with or without pancreatoduodenectomy (PD), plus extrahepatic Bile Duct resection and regional lymphadenectomy has recently been recognized as the standard curative treatment for hilar Bile Duct Cancer. On the other hand, PD is the choice of treatment for middle and distal Bile Duct Cancer. Major hepatectomy concomitant with PD (hepatopancreatoduodenectomy) has been applied to selected patients with widespread tumors. Preoperative biliary drainage (BD) followed by portal vein embolization (PVE) enables major hepatectomy in patients with hilar Bile Duct Cancer without mortality. BD should be performed considering the surgical procedure, especially, in patients with separated intrahepatic Bile Ducts caused by hilar Bile Duct Cancer. Right or left trisectoriectomy are indicated according to the tumor spread and biliary anatomy. As a result, extended radical resection offers a chance for cure of hilar Bile Duct Cancer with improved resectability, curability, and a 5-year survival rate of 40%. A 5-year survival rate has ranged from 24% to 39% after PD for middle and distal Bile Duct Cancer.
-
Current surgical treatment for Bile Duct Cancer HIGHLIGHT TOPICS
2007Co-Authors: Yasuji Seyama, Masatoshi Makuuchi, Wei TangAbstract:Since extrahepatic Bile Duct Cancer is difficult to diagnose and to cure, a safe and radical surgical strategy is needed. In this review, the modes of infiltration and spread of extrahepatic Bile Duct Cancer and surgical strategy are discussed. Extended hemihepatectomy, with or without pancreatoduodenectomy (PD), plus extrahepatic Bile Duct resection and regional lymphadenectomy has recently been recognized as the standard curative treatment for hilar Bile Duct Cancer. On the other hand, PD is the choice of treatment for middle and distal Bile Duct Cancer. Major hepatectomy concomitant with PD (hepatopancreatoduodenectomy) has been applied to selected patients with widespread tumors. Preoperative biliary drainage (BD) followed by portal vein embolization (PVE) enables major hepatectomy in patients with hilar Bile Duct Cancer without mortality. BD should be performed considering the surgical procedure, especially, in patients with separated intrahepatic Bile Ducts caused by hilar Bile Duct Cancer. Right or left trisectoriectomy are indicated according to the tumor spread and biliary anatomy. As a result, extended radical resection offers a chance for cure of hilar Bile Duct Cancer with improved resectability, curability, and a 5-year survival rate of 40%. A 5-year survival rate has ranged from 24% to 39% after PD for middle and distal Bile Duct Cancer.
-
long term outcome of extended hemihepatectomy for hilar Bile Duct Cancer with no mortality and high survival rate
Annals of Surgery, 2003Co-Authors: Yasuji Seyama, Tadatoshi Takayama, Keiichi Kubota, Tomoo Kosuge, Keiji Sano, Tamaki Noie, Masatoshi MakuuchiAbstract:Hilar Bile Duct Cancer is known to be a slow-growing and late-metastasizing tumor, but its anatomic location and longitudinal extent along the Bile Duct have made curative resection difficult, resulting in low resectability, high mortality, and poor long-term survival.1–5 Recently, major hepatectomy has been advocated for complete tumor clearance, and since then resectability and long-term survival rates have improved.6–17 However, because most patients with hilar Bile Duct Cancer have obstructive jaundice, major hepatectomy is not always safe, contributing to high morbidity and mortality rates.3,5,7,8,10–18 Therefore, a safe and curative strategy is required for hilar Bile Duct Cancer to reduce operative risk and improve long-term survival. We consider the following elements to be vital for such a strategy: a proper choice of surgical procedure, appropriate preoperative treatment, skillful surgical technique, and careful postoperative management. In this report, we retrospectively review the records of 58 consecutive major hepatectomies, we describe our strategy for curative resection for hilar Bile Duct Cancer, and we discuss the short- and long-term results, paying attention to the risks and benefits of major hepatectomy.
Ginji Endo - One of the best experts on this subject based on the ideXlab platform.
-
Risk of Bile Duct Cancer among printing workers exposed to 1,2-dichloropropane and/or dichloromethane.
Journal of occupational health, 2015Co-Authors: Tomotaka Sobue, Mai Utada, Yuko Ohno, Takeshi Makiuchi, Shinichiro Uehara, Tomoshige Hayashi, Kyoko Kogawa Sato, Ginji EndoAbstract:Risk of Bile Duct Cancer among printing workers exposed to 1,2-dichloropropane and/or dichloromethane: Tomotaka SOBUE, et al. Department of Environmental Medicine and Population Sciences, Graduate School of Medicine, Osaka University— Objectives: We conDucted a retrospective cohort study to examine the risk of Bile Duct Cancer among current and former workers in the offset color proof printing department at a printing company in Osaka, Japan. Methods: Standardized incidence ratios (SIRs) between January 1, 1985, and December 31, 2012, were estimated for the cumulative years of exposure to two chemicals, dichloromethane (DCM) and 1,2-dichlo- ropropane (1,2-DCP), using the national incidence level as a reference. In addition, we examined risk patterns by the calendar year in which observation started. Results: Among 106 workers with a total of 1,452.4 person-years of exposure, 17 Bile Duct Cancer cases were observed, resulting in an estimated overall SIR of 1,132.5 (95% confidence interval (CI): 659.7−1,813.2). The SIR was 1,319.9 (95% CI: 658.9−2,361.7) for those who were exposed to both DCM and 1,2-DCP, and it was 1,002.8 (95% CI: 368.0−2,182.8) for those exposed to 1,2-DCP only. SIRs tended to increase according to years of exposure to 1,2-DCP but not DCM when a 5- year lag time was assumed. The SIRs were higher for the cohorts in which observation started in 1993−2000, particularly in cohorts in which it started in 1996−1999, compared with those in which it started before or after 1993−2000. Conclusions: We observed an extraor- dinarily high risk of Bile Duct Cancer among the offset color proof printing workers. Elevated risk may be
-
risk of Bile Duct Cancer among printing workers exposed to 1 2 dichloropropane and or dichloromethane
Journal of Occupational Health, 2015Co-Authors: Tomotaka Sobue, Mai Utada, Yuko Ohno, Takeshi Makiuchi, Shinichiro Uehara, Tomoshige Hayashi, Kyoko Kogawa Sato, Ginji EndoAbstract:Risk of Bile Duct Cancer among printing workers exposed to 1,2-dichloropropane and/or dichloromethane: Tomotaka SOBUE, et al. Department of Environmental Medicine and Population Sciences, Graduate School of Medicine, Osaka University— Objectives: We conDucted a retrospective cohort study to examine the risk of Bile Duct Cancer among current and former workers in the offset color proof printing department at a printing company in Osaka, Japan. Methods: Standardized incidence ratios (SIRs) between January 1, 1985, and December 31, 2012, were estimated for the cumulative years of exposure to two chemicals, dichloromethane (DCM) and 1,2-dichlo- ropropane (1,2-DCP), using the national incidence level as a reference. In addition, we examined risk patterns by the calendar year in which observation started. Results: Among 106 workers with a total of 1,452.4 person-years of exposure, 17 Bile Duct Cancer cases were observed, resulting in an estimated overall SIR of 1,132.5 (95% confidence interval (CI): 659.7−1,813.2). The SIR was 1,319.9 (95% CI: 658.9−2,361.7) for those who were exposed to both DCM and 1,2-DCP, and it was 1,002.8 (95% CI: 368.0−2,182.8) for those exposed to 1,2-DCP only. SIRs tended to increase according to years of exposure to 1,2-DCP but not DCM when a 5- year lag time was assumed. The SIRs were higher for the cohorts in which observation started in 1993−2000, particularly in cohorts in which it started in 1996−1999, compared with those in which it started before or after 1993−2000. Conclusions: We observed an extraor- dinarily high risk of Bile Duct Cancer among the offset color proof printing workers. Elevated risk may be
-
Long-term Trends in Incidence and Mortality of Intrahepatic and Extrahepatic Bile Duct Cancer in Japan
Journal of epidemiology, 2014Co-Authors: Mai Utada, Yuko Ohno, Tomoko Tamaki, Tomotaka Sobue, Ginji EndoAbstract:Background A report of multiple cases of Bile Duct Cancer at a Japanese printing company raised concern about such Cancers. We examined long-term trends in Bile Duct Cancer in Japan.
-
prevalence of Bile Duct Cancer among printing industry workers in comparison with other industries
Journal of Occupational Health, 2013Co-Authors: Etsuji Okamoto, Kiyotaka Kikuchi, Ginji EndoAbstract:OBJECTIVES The aim of this study was to assess the risk of developing Bile Duct Cancer among workers in the other printing industry in comparison with workers in all industries in general. METHODS Prevalence of Bile Duct Cancer was compared between workers in the printing industry and age-standardized controls in all other industries using the claims database of the Japan Health Insurance Association, which insures workers of small-medium sized employers of all industries. RESULTS Young (aged 30-49) male workers in the printing industry showed an elevated but insignificant standardized prevalence rate ratio (SPRR) for Bile Duct Cancer in comparison with workers in all other industries (SPRR: 1.78; 95%CI: 0.63-5.00). The risk was higher for intrahepatic Bile Duct Cancer but remained insignificant (SPRR: 3.03; 95%CI: 0.52-17.56). CONCLUSIONS The sharply elevated risk of Bile Duct Cancer observed among proof-printing workers of a printing factory in Osaka may not be generalizable to workers in the printing industry nationwide.
Yasuji Seyama - One of the best experts on this subject based on the ideXlab platform.
-
Current surgical treatment for Bile Duct Cancer.
World journal of gastroenterology, 2007Co-Authors: Yasuji Seyama, Masatoshi MakuuchiAbstract:Since extrahepatic Bile Duct Cancer is difficult to diagnose and to cure, a safe and radical surgical strategy is needed. In this review, the modes of infiltration and spread of extrahepatic Bile Duct Cancer and surgical strategy are discussed. Extended hemihepatectomy, with or without pancreatoduodenectomy (PD), plus extrahepatic Bile Duct resection and regional lymphadenectomy has recently been recognized as the standard curative treatment for hilar Bile Duct Cancer. On the other hand, PD is the choice of treatment for middle and distal Bile Duct Cancer. Major hepatectomy concomitant with PD (hepatopancreatoduodenectomy) has been applied to selected patients with widespread tumors. Preoperative biliary drainage (BD) followed by portal vein embolization (PVE) enables major hepatectomy in patients with hilar Bile Duct Cancer without mortality. BD should be performed considering the surgical procedure, especially, in patients with separated intrahepatic Bile Ducts caused by hilar Bile Duct Cancer. Right or left trisectoriectomy are indicated according to the tumor spread and biliary anatomy. As a result, extended radical resection offers a chance for cure of hilar Bile Duct Cancer with improved resectability, curability, and a 5-year survival rate of 40%. A 5-year survival rate has ranged from 24% to 39% after PD for middle and distal Bile Duct Cancer.
-
Current surgical treatment for Bile Duct Cancer HIGHLIGHT TOPICS
2007Co-Authors: Yasuji Seyama, Masatoshi Makuuchi, Wei TangAbstract:Since extrahepatic Bile Duct Cancer is difficult to diagnose and to cure, a safe and radical surgical strategy is needed. In this review, the modes of infiltration and spread of extrahepatic Bile Duct Cancer and surgical strategy are discussed. Extended hemihepatectomy, with or without pancreatoduodenectomy (PD), plus extrahepatic Bile Duct resection and regional lymphadenectomy has recently been recognized as the standard curative treatment for hilar Bile Duct Cancer. On the other hand, PD is the choice of treatment for middle and distal Bile Duct Cancer. Major hepatectomy concomitant with PD (hepatopancreatoduodenectomy) has been applied to selected patients with widespread tumors. Preoperative biliary drainage (BD) followed by portal vein embolization (PVE) enables major hepatectomy in patients with hilar Bile Duct Cancer without mortality. BD should be performed considering the surgical procedure, especially, in patients with separated intrahepatic Bile Ducts caused by hilar Bile Duct Cancer. Right or left trisectoriectomy are indicated according to the tumor spread and biliary anatomy. As a result, extended radical resection offers a chance for cure of hilar Bile Duct Cancer with improved resectability, curability, and a 5-year survival rate of 40%. A 5-year survival rate has ranged from 24% to 39% after PD for middle and distal Bile Duct Cancer.
-
long term outcome of extended hemihepatectomy for hilar Bile Duct Cancer with no mortality and high survival rate
Annals of Surgery, 2003Co-Authors: Yasuji Seyama, Tadatoshi Takayama, Keiichi Kubota, Tomoo Kosuge, Keiji Sano, Tamaki Noie, Masatoshi MakuuchiAbstract:Hilar Bile Duct Cancer is known to be a slow-growing and late-metastasizing tumor, but its anatomic location and longitudinal extent along the Bile Duct have made curative resection difficult, resulting in low resectability, high mortality, and poor long-term survival.1–5 Recently, major hepatectomy has been advocated for complete tumor clearance, and since then resectability and long-term survival rates have improved.6–17 However, because most patients with hilar Bile Duct Cancer have obstructive jaundice, major hepatectomy is not always safe, contributing to high morbidity and mortality rates.3,5,7,8,10–18 Therefore, a safe and curative strategy is required for hilar Bile Duct Cancer to reduce operative risk and improve long-term survival. We consider the following elements to be vital for such a strategy: a proper choice of surgical procedure, appropriate preoperative treatment, skillful surgical technique, and careful postoperative management. In this report, we retrospectively review the records of 58 consecutive major hepatectomies, we describe our strategy for curative resection for hilar Bile Duct Cancer, and we discuss the short- and long-term results, paying attention to the risks and benefits of major hepatectomy.
Tomoo Kosuge - One of the best experts on this subject based on the ideXlab platform.
-
Is extended hemihepatectomy plus pancreaticoduodenectomy justified for advanced Bile Duct Cancer and gallbladder Cancer
Surgery, 2013Co-Authors: Yoshihiro Sakamoto, Satoshi Nara, Yoji Kishi, Minoru Esaki, Kazuaki Shimada, Norihiro Kokudo, Tomoo KosugeAbstract:Background Major hepatopancreaticoduodenectomy (HPD) is an extensive surgical procedure offering the highest curability for patients with advanced biliary Cancer. However, surgical morbidity associated with major HPD is high, and optimal indications for this procedure remain unclear. Methods Between 1989 and 2010, 14 patients with widespread Bile Duct Cancer and 5 with gallbladder Cancer having biliary infiltration underwent major HPD at our hospital. Preoperative portal vein embolization was performed in 17 patients undergoing right HPD. Clinicopathologic factors and survivals following HPD were compared between patients with Bile Duct Cancer and those with gallbladder Cancer. Results One patient who underwent right HPD for gallbladder Cancer died of hepatic failure (5.3%) and 18 of the 19 patients (95%) developed postoperative pancreatic fistulas. The median hospital stay was 47 days. Depth of invasion was T3 in 1 patient and T4 in 2 patients with Bile Duct Cancer and was T4 in all 5 patients with gallbladder Cancer (P = .002). The clinical stage was IV in 3 patients (21%) with Bile Duct Cancer and in all 5 patients with gallbladder Cancer (P = .002). The 5-year survival rates and median survival rates of patients with Bile Duct Cancer and gallbladder Cancer were 45% vs 0 and 3.3 years vs 8 months, respectively (P Conclusion HPD can be an acceptable treatment option for widespread Bile Duct Cancer. However, the indication for HPD in advanced-stage gallbladder Cancer should be considered carefully, considering the high morbidity rate and the advanced stage of the disease.
-
prognosis of perihilar cholangiocarcinoma hilar Bile Duct Cancer versus intrahepatic cholangiocarcinoma involving the hepatic hilus
Annals of Surgical Oncology, 2008Co-Authors: Tsuyoshi Sano, Yoshihiro Sakamoto, Minoru Esaki, Kazuaki Shimada, Hidenori Ojima, Tomoo KosugeAbstract:Background Clinically hepatobiliary resection is indicated for both hilar Bile Duct Cancer (BDC) and intrahepatic cholangiocarcinoma involving the hepatic hilus (CCC). The aim of this study was to compare the long-term outcome of BDC and CCC.
-
Extended right hemihepatectomy as a salvage operation for recurrent Bile Duct Cancer 3 years after pancreatoduodenectomy.
Japanese journal of clinical oncology, 2006Co-Authors: Taizo Hibi, Yoshihiro Sakamoto, Kazuaki Shimada, Tsuyoshi Sano, Naobumi Tochigi, Hidenori Ojima, Tomoo KosugeAbstract:Salvage surgery for recurrent Bile Duct Cancer is generally impractical due to local invasion of surrounding major vascular structures or distant metastases. We describe a case of a relapsed tumor in the right hepatic Duct 3 years after pancreatoduodenectomy for middle to distal Bile Duct Cancer. The recurrent tumor, measuring 25 x 12 x 12 mm, was mostly confined within the right hepatic Duct. It displayed an intraDuctal superficial extension rather than transmural invasive growth to the hepatic hilum. An extended right hemihepatectomy was successfully performed with a histologically negative margin. The patient is currently doing well without any signs of local recurrence or distant metastasis 8 months after the second operation. Precise pathological examination revealed that the lesion had originated from multicentric foci in the right hepatic Duct, not as a result of anastomotic recurrence. These results raised the consideration of a potentially more indolent subgroup of Bile Duct Cancer. This is a detailed report of a successfully resected recurrent Bile Duct Cancer, for which the patient underwent major hepatectomy as a salvage procedure after pancreatoduodenectomy for the primary tumor. An aggressive surgical approach will be a rational treatment of choice for recurrent disease when metachronous multicentric tumor development in the Bile Duct is suspected and curative resection can be safely performed.
-
long term outcome of extended hemihepatectomy for hilar Bile Duct Cancer with no mortality and high survival rate
Annals of Surgery, 2003Co-Authors: Yasuji Seyama, Tadatoshi Takayama, Keiichi Kubota, Tomoo Kosuge, Keiji Sano, Tamaki Noie, Masatoshi MakuuchiAbstract:Hilar Bile Duct Cancer is known to be a slow-growing and late-metastasizing tumor, but its anatomic location and longitudinal extent along the Bile Duct have made curative resection difficult, resulting in low resectability, high mortality, and poor long-term survival.1–5 Recently, major hepatectomy has been advocated for complete tumor clearance, and since then resectability and long-term survival rates have improved.6–17 However, because most patients with hilar Bile Duct Cancer have obstructive jaundice, major hepatectomy is not always safe, contributing to high morbidity and mortality rates.3,5,7,8,10–18 Therefore, a safe and curative strategy is required for hilar Bile Duct Cancer to reduce operative risk and improve long-term survival. We consider the following elements to be vital for such a strategy: a proper choice of surgical procedure, appropriate preoperative treatment, skillful surgical technique, and careful postoperative management. In this report, we retrospectively review the records of 58 consecutive major hepatectomies, we describe our strategy for curative resection for hilar Bile Duct Cancer, and we discuss the short- and long-term results, paying attention to the risks and benefits of major hepatectomy.
Sun Whe Kim - One of the best experts on this subject based on the ideXlab platform.
-
Ceruloplasmin as a prognostic marker in patients with Bile Duct Cancer.
Oncotarget, 2017Co-Authors: In Woong Han, Jin-young Jang, Woo Il Kwon, Taesung Park, Yongkang Kim, Kyoung Bun Lee, Sun Whe KimAbstract:// In Woong Han 1, 2 , Jin-Young Jang 2 , Wooil Kwon 2 , Taesung Park 3 , Yongkang Kim 3 , Kyoung Bun Lee 4 , Sun-Whe Kim 2 1 Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Gangnam-Gu, Seoul 06351, Korea 2 Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Chongno-Gu, Seoul 110-744, Korea 3 Department of Statistics, Seoul National University College of Natural Sciences, Gwanak-Gu, Seoul 08826, Korea 4 Department of Pathology, Seoul National University College of Medicine, Chongno-Gu, Seoul 110-744, Korea Correspondence to: Jin-Young Jang, email: jangjy4@snu.ac.kr Keywords: Bile Duct, Cancer, cholangiocarcinoma, biomarker, ceruloplasmin Received: November 09, 2016 Accepted: February 06, 2017 Published: March 07, 2017 ABSTRACT Background and Aims: Bile Duct Cancer is one of the lethal Cancers, presenting difficulties in early diagnosis and limited treatment modalities. Despite current advances in biomarker research, most studies have been performed in Western populations. Therefore, the purpose of this study was to determine a prognostic marker for Bile Duct Cancer, especially in Korean patients, whose incidence of Bile Duct Cancer is high. Results: Comparing Cancer and normal Bile Duct tissue, we identified 29091 differentially expressed genes. CP, SCEL, and MUC16 had positive coefficients with a log2 ratio >1 for advanced T, N stage and perineural invasion Cancer tissue. Strong immunohistochemical expression of ceruloplasmin was dominant in tumors with advanced T stage (p>0.999) and perineural invasion (p=0.316). Patients and Methods: We performed tissue microarray experiment with 79 Bile Duct Cancer tissue samples and 21 normal Bile Duct tissue samples. Candidate genes that has positive correlation with T, N stage and perineural invasion were drawn with multivariate analysis. Tissue expression of the genes was evaluated with an immunohistochemical study. Conclusions: Ceruloplasmin is supposed to be related with advanced T stage and perineural invasion, having a possibility as a candidate prognostic marker for Bile Duct Cancer.
-
Actual long-term outcome of extrahepatic Bile Duct Cancer after surgical resection
Annals of surgery, 2005Co-Authors: Jin-young Jang, Sun Whe Kim, Joong Park, Young Jun Ahn, Yoo Seok Yoon, Min Gew Choi, Kyung-suk Suh, Kuhn Uk Lee, Yong Hyun ParkAbstract:Although reported 5-year survival rates of extrahepatic Bile Duct Cancer lie between 20% and 30%, these data do not reflect the actual cure rate. Some patients survive longer than 5 years with recurrent disease. In some patients, recurrence is detected after 5 years. Accordingly, true cure rate is probably substantially lower than the 5-year survival rate reported in curatively resected cases. Sometimes patients survive a few years after a drainage procedure only, and others who undergo resection with microscopic tumor involvement of the Bile Duct margin survive longer than expected. Such rather unusual outcomes probably stem from the slow-growing characteristics of the tumor. Moreover, the majority of studies that have reported prognostic factors and survival outcome1–7 have been limited because few studies have been large enough in scope, with respect to patient number and/or long term follow up to properly determine the actual long-term clinical course. Extrahepatic Bile Duct Cancer is usually classified as upper, middle, or distal Bile Duct Cancer according to the anatomic location8; however, tumors are rarely confined to 1 segment because Bile Duct Cancer tends to spread along the Bile Duct wall longitudinally. Pancreatoduodenectomy is generally performed in cases of distal and mid third Cancer (common Bile Duct Cancer) and Bile Duct resection, without or with hepatectomy (hepatobiliary resection), for proximal third Cancer (common hepatic Duct and Klatskin tumor). Moreover, it seems reasonable that survival analysis based on the type of resection would be more practical and helpful to surgeons rather than the poorer definable location-based system currently used. The purpose of this study was to determine actual survival in patients with extrahepatic Bile Duct Cancer according to resection type, at least to the postoperative 5-year stage, and to identify those factors associated with long-term survival. We also investigated the status of patients at the 5-year stage to include late recurrence and recurrence pattern in our analysis of long-term outcome.
-
role of postoperative radiotherapy in the management of extrahepatic Bile Duct Cancer
International Journal of Radiation Oncology Biology Physics, 2002Co-Authors: Suzy Kim, Sun Whe Kim, Yong Joo Bang, Dae Seog HeoAbstract:Abstract Purpose: To analyze the outcome of postoperative radiotherapy (RT) or chemoradiation for patients with extrahepatic Bile Duct Cancer who had undergone either curative or palliative surgery, and to identify the prognostic factors for these patients. Methods and Materials: Between March 1982 and December 1994, 91 patients with extrahepatic Bile Duct Cancer underwent RT at the Department of Therapeutic Radiology, Seoul National University Hospital. Of these patients, 84 were included in this retrospective study. The male/female ratio was 3.7:1 (66 men and 18 women). The median age of the patients was 58 years (range 33–76). Gross total surgical resection was performed in 72 patients, with pathologically negative margins in 47 and microscopically positive margins in 25. Twelve patients underwent surgical exploration and biopsy or subtotal resection with palliative bypass procedures. All the patients received >40 Gy of external beam RT after surgery. Concurrent 5-fluorouracil was administered during external beam RT in 71 patients, and maintenance chemotherapy was performed in 61 patients after RT completion. The minimal follow-up of the survivors was 14 months, and the median follow-up period for all the patients was 23 months (range 2–75). Results: The overall 2- and 5-year survival rate was 52% and 31%, respectively. The 2- and 5-year disease-free survival rate was 48% and 26%, respectively. On univariate analysis using the Kaplan-Meier proDuct limit method, the use of chemotherapy, performance status, N stage, size of residual tumor, stage, and tumor location were significant prognostic factors. However, on multivariate analysis using Cox's proportional hazard model, N stage (N0 vs. N1 and N2, p = 0.02) was the only significant prognostic factor. Conclusion: Long-term survival can be expected in patients with extrahepatic Bile Duct Cancer who undergo radical surgery and postoperative chemoradiation. Regional lymph node metastasis is a poor prognostic factor for these patients.