BACKGROUND/AIMS: @entity1126 progresses slowly but easily invades the nearby portal vein or hepatic artery. Thus, in some cases, curative resection is impossible, so we need to determine the best non-surgical treatments for this @entity5 . METHODOLOGY: We classified 98 @entity1 with @entity1157 cancer into 3 categories: a non-surgical group (34 cases), an exploratory laparotomy group (9 cases), and a surgical resection group (55 cases). Survival rates were examined in the light of clinical factors. RESULTS: In the non-surgical group, extensive vessel invasion was the most common reason for unresectability (13 cases), with broad biliary extension the second most common (11 cases). In the exploratory laparotomy group the most common reason for unresectability was severe vessel invasion (6 cases). Cumulative 1- and 2-year survival rates for @entity1 with unresectable @entity5 without distant @entity3 were 26.9% and 7.2%, respectively. One- and 2-year survival rates for @entity1 with unresectable @entity5 and with total @entity648 of less than 2 mg/dL on discharge were 36.8% and 9.8%, respectively. The 1-year survival rate with placement of an expandable metallic stent was as high as 55.6%; without the stent it was 7.1% (P = 0.005). Radiation therapy gave a better prognosis than did no radiation (P = 0.01). CONCLUSIONS: Portal and arterial invasion were the principal reasons for unresectability. Use of an expandable metallic stent or radiation therapy, and a total @entity648 level of less than 2 mg/dL on discharge, were factors that enhanced survival in unresectable cases, but distant @entity3 , dissemination, and poor general condition or liver function were negative factors for survival.

Management of unresectable XXXX cancer--preoperative diagnosis, treatment selection, and clinical outcome.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity5 :: ('MESH:D009369', 'Disease') :: ['tumor', 'tumors'] @entity1157 :: ('MESH:D001649', 'Disease') :: ['hilar bile duct'] @entity648 :: ('MESH:D001663', 'Chemical') :: ['bilirubin'] @entity1126 :: ('MESH:D001650', 'Disease') :: ['Hilar bile duct cancer'] @entity3 :: ('MESH:D009362', 'Disease') :: ['metastasis']
@entity1157 :: (MESH:D001649,Disease) :: ['hilar bile duct']
