Biliary tract cancer is traditionally associated with a grim prognosis because of the difficulty in diagnosing at an early stage and the relative inefficiency of adjuvant treatments. However, a policy of extensive resection has been developed over the past few years, including resection of the extrahepatic bile duct, en block dissection of the regional lymph nodes and perineural tissue, and resection of the liver or pancreas when these are required to obtain tumor-free resection margins. The most significant recent advances are a better knowledge of the histologic spread of these tumors and the confirmation that improved survival and even a complete cure may be anticipated from radical surgery.
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