XXXX : surgery alone versus surgery plus postoperative radiation therapy.

@entity1 @entity41 @entity5 @entity1126 @entity177 @entity3
PURPOSE: The goal of this study was to determine the role of radiotherapy after curative-intent surgery in the management of extrahepatic bile duct (EHBD) @entity5 . METHODS AND MATERIALS: From 1997 through 2005, 78 @entity1 with @entity1126 were surgically staged. These @entity1 were stratified by the absence of adjuvant radiation (n = 47, group I) versus radiation (n = 31, group II) after resection. Pathology examination showed 27 cases in group I and 20 cases in group II had microscopically positive resection margins. The @entity1 in group II received 45 to 54 Gy of external beam radiotherapy. The primary endpoints of this study were overall survival, disease-free survival, and prognostic factors. RESULTS: There were no differences between the 5-year overall survival rates for the two groups (11.6% in group I vs. 21% in group II). However, the @entity1 with microscopically positive resection margins who received adjuvant radiation therapy had higher median disease-free survival rates than those who underwent surgery alone (21 months vs. 10 months, respectively, p = 0.042). @entity177 was found in @entity1 who received postoperative radiotherapy (61.7% in group I and 35.6% in group II, p = 0.02). Outcomes of the @entity1 with a positive resection margin and lymph node @entity3 who received postoperative radiation therapy were doubled compared to those of @entity1 without adjuvant radiotherapy. Resection margin status, lymph node @entity3 , and pathology differentiation were significant prognostic factors in disease-free survival. CONCLUSIONS: Adjuvant radiotherapy might be useful in @entity1 with @entity1126 , especially for those @entity1 with microscopic @entity41 and positive lymph nodes after resection for increasing local control.
