Experience in twenty patients with carcinoma of hilar bile duct treated by resection, targeting chemotherapy and intracavitary irradiation.

Three years ago, we reported a new treatment modality for carcinoma of the hilar bile duct consisting of limited hepatic hilar resection with selective adjuvant therapies by local chemotherapy using a new drug delivery system and by intracavitary 60Co irradiation using a remote after loading system. This treatment was applied in 20 patients by April 1991 and the results are fairly good. The overall one, three and five year survival rates are 80, 33 and 26 percent, respectively, which are better than those reported. No serious complications have been observed after operation and adjuvant therapies. Comparing the survival rate and prognostic factors, it was proved that the prognostic factors were not influential in the 20 patients. For the further improvement of this treatment modality, some special devices will be necessary to treat not only the resection stump but also the excisional surface of the tumor.