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Unresectability AND cholangiocarcinoma

Li-Ye Wang, Shuai Gong, Li-Ping Gao, Li-Xia Hou, Wei He
RATIONALE: Intrahepatic cholangiocarcinoma (ICC) originates from the secondary branch of the bile duct and the intrahepatic bile duct epithelial cells, and is a rare pathological type of primary liver cancer. Recently, apatinib has been successfully used for a variety of malignancies. PATIENT CONCERNS: A 23-year-old female was noted with intermittent right upper abdominal distension, abdominal pain, and vomiting after eating for more than 1 month. The enhanced CT scan revealed multiple intrahepatic lesions, portal vein and right branch tumor emboli were present...
December 2018: Medicine (Baltimore)
Ryusei Matsuyama, Daisuke Morioka, Ryutaro Mori, Yasuhiro Yabushita, Seigo Hiratani, Yohei Ota, Takafumi Kumamoto, Itaru Endo
BACKGROUND: The concept of "borderline resectable" was recently introduced to the field of surgery for pancreatic cancer, and surgical outcomes for this disease with extremely dismal prognosis have improved since the introduction of this concept. However, no such concept has yet been introduced to the field of surgery for hilar cholangiocarcinoma (HCca). AIM: To determine a definition and criteria for "borderline resectable" in the field of surgery for HCca...
December 7, 2018: World Journal of Surgery
Daniel R Waisberg, Rafael S Pinheiro, Lucas S Nacif, Vinicius Rocha-Santos, Rodrigo B Martino, Rubens M Arantes, Liliana Ducatti, Quirino Lai, Wellington Andraus, Luiz C D'Albuquerque
Intrahepatic cholangiocarcinoma (ICC) is the second most prevalent primary liver neoplasm after hepatocellular carcinoma (HCC), corresponding to 10% to 15% of cases. Pathologies that cause chronic biliary inflammation and bile stasis are known predisposing factors for development of ICC. The incidence and cancer-related mortality of ICC is increasing worldwide. Most patients remain asymptomatic until advance stage, commonly presenting with a liver mass incidentally diagnosed. The only potentially curative treatment available for ICC is surgical resection...
2018: Translational Gastroenterology and Hepatology
Stefan Stremitzer, Robert P Jones, Leonard M Quinn, Stephen W Fenwick, Rafael Diaz-Nieto, Graeme J Poston, Hassan Z Malik
BACKGROUND: Liver transplantation in patients with unresectable early-stage (<3 cm, node negative) hilar cholangiocarcinoma has been recently reported to be associated with longer survival compared to liver resection and therefore suggested as potential treatment option also in resectable disease. Here, we investigated the outcome of resection in early-stage tumours as the standard of care in an experienced European centre. METHODS: Patients with de novo resectable hilar cholangiocarcinomas who underwent liver resection between mid-2009 and December 2017 were classified as early-stage (<3 cm and node negative) or later-stage tumours (≥3 cm and/or node positive), and were investigated with respect to clinical outcome...
October 16, 2018: European Journal of Surgical Oncology
Merel S Koedijk, Ben J M Heijmen, Bas Groot Koerkamp, Ferry A L M Eskens, Dave Sprengers, Jan-Werner Poley, Dik C van Gent, Luc J W van der Laan, Bronno van der Holt, François E J A Willemssen, Alejandra Méndez Romero
INTRODUCTION: For patients with perihilar cholangiocarcinoma (CCA), surgery is the only treatment modality that can result in cure. Unfortunately, in the majority of these patients, the tumours are found to be unresectable at presentation due to either local invasive tumour growth or the presence of distant metastases. For patients with unresectable CCA, palliative chemotherapy is the standard treatment yielding an estimated median overall survival (OS) of 12-15.2 months. There is no evidence from randomised trials to support the use of stereotactic body radiation therapy (SBRT) for CCA...
October 15, 2018: BMJ Open
Pamela J Boimel, Kim Reiss Binder, Theodore S Hong, Mary Feng, Edgar Ben-Josef
Cholangiocarcinoma and gallbladder malignancies are aggressive gastrointestinal malignancies with management dependent on resectability, comorbidities, and location. A multidisciplinary discussion with medical oncologists, radiation oncologists, and surgeons is necessary to determine the optimal treatment approach for each patient. Surgical resection offers the best chance for a long-term cure. Recent studies, such as the phase II SWOG S0809 and the phase III BILCAP study have highlighted the importance of adjuvant treatment with radiation therapy and chemotherapy, respectively, in resected disease...
October 2018: Seminars in Radiation Oncology
Florence K Keane, Andrew X Zhu, Theodore S Hong
Biliary tract cancers (BTCs), including intrahepatic, perihilar and distal cholangiocarcinomas, and gallbladder cancers, are a heterogeneous cohort of tumors that tend to present with advanced stage and with high rates of recurrence after surgical resection. While liver-directed radiotherapy was traditionally restricted to the palliative setting given concerns over hepatotoxicity, modern radiotherapy techniques have enabled safe and effective treatment of a variety of hepatic tumors, thereby expanding the role of liver-directed radiotherapy in the management of BTCs...
October 2018: Seminars in Radiation Oncology
Edward C Lo, Adam N Rucker, Michael P Federle
Hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC) comprise the majority of primary liver cancers. Both HCC and ICC have characteristic imaging appearances on multiphase computed tomography (CT) and magnetic resonance imaging (MRI). Several locoregional therapies, including radiation therapy, are used to treat unresectable disease and residual or recurrent tumor. The tumor response following locoregional therapies has variable imaging manifestations. Focal liver reaction, the imaging changes of the liver following radiation treatment, should be recognized and not mistaken for tumor...
October 2018: Seminars in Radiation Oncology
Wei-Wen Chang, Ping-Kun Hsiao, Lei Qin, Chia-Lun Chang, Jyh-Ming Chow, Szu-Yuan Wu
PURPOSE: No prospective randomized trials have been conducted to date to evaluate the efficacy of palliation of pain or jaundice without treatment, definitive concurrent chemoradiotherapy (CCRT), sequential chemotherapy and radiotherapy (CTRT), or chemotherapy (CT) alone for treating unresectable intrahepatic cholangiocarcinoma (ICC). We designed a nationwide, population-based, cohort study to determine the effects of different treatments on patients with unresectable ICC using propensity score matching (PSM) with the Mahalanobis metric...
November 2018: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Koichiro Sakata, Daiki Kijima, Taizo Yamaguchi, Takashi Furuhashi, Toshihiko Abe, Haruki Iwamoto, Katsuhiko Morita
INTRODUCTION: Although curative resection is an outstanding prognostic factor of intrahepatic cholangiocarcinoma (ICC), certain segments remain unresectable. The standard therapy for initially unresectable ICC is uncertain. In this case report, we reported the feasibility of multimodal chemotherapy and curative resection. CASE: A 59-year-old Asian woman with back pain was referred to the hospital by her family physician regarding liver mass visible on ultrasonography...
2018: International Journal of Surgery Case Reports
Steffen Marquardt, Martha M Kirstein, Roland Brüning, Martin Zeile, Pier Francesco Ferrucci, Warner Prevoo, Boris Radeleff, Hervé Trillaud, Lambros Tselikas, Emilio Vicente, Philipp Wiggermann, Michael P Manns, Arndt Vogel, Frank K Wacker
OBJECTIVES: Cholangiocarcinoma is the second most common primary liver tumour with a poor overall prognosis. Percutaneous hepatic perfusion (PHP) is a directed therapy for primary and secondary liver malignancies, and its efficacy and safety have been shown in different entities. The purpose of this study was to prove the safety and efficacy of PHP in patients with unresectable intrahepatic cholangiocarcinoma (iCCA). PATIENTS AND METHODS: We retrospectively reviewed data from 15 patients with unresectable iCCA treated with PHP in nine different hospitals throughout Europe...
September 25, 2018: European Radiology
G Lurje, J Bednarsch, C Roderburg, C Trautwein, U P Neumann
Cholangiocarcinoma (CCC) is the second most common primary malignancy of the liver and is typically diagnosed at advanced disease stages. Among curative treatment options for CCC, radical surgical resection with extrahepatic bile duct resection, hepatectomy, and en-bloc lymphadenectomy are considered the mainstay of curative therapy. The assessment of the functional liver reserve by dynamic liver function tests and the estimation of the remaining future liver volume (future liver remnant, FLR) are of paramount importance...
November 2018: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
Dalia Elganainy, Emma B Holliday, Cullen M Taniguchi, Grace L Smith, Rachna Shroff, Milind Javle, Kanwal Raghav, Ahmed Kaseb, Thomas A Aloia, Jean Nicolas Vauthey, Ching-Wei D Tzeng, Joseph M Herman, Albert C Koong, Sunil X Krishnan, Bruce D Minsky, Christopher H Crane, Prajnan Das, Eugene J Koay
PURPOSE: To evaluate the effect of escalated dose radiation therapy (EDR, defined as doses >50.4 Gy in 28 fractions [59.5 Gy BED]) on overall survival (OS), freedom from local progression (FFLP), and freedom from distant progression (FFDP) of patients with unresectable extrahepatic cholangiocarcinoma (EHCC). METHODS: A consecutive cohort of 80 patients who underwent radiotherapy for unresectable EHCC from 2001 to 2015 was identified. Demographic, tumor, treatment, toxicity, and laboratory variables were collected...
October 2018: Cancer Medicine
Ankur Pandey, Pallavi Pandey, Mounes Aliyari Ghasabeh, Manijeh Zarghampour, Pegah Khoshpouri, Sanaz Ameli, Yan Luo, Ihab R Kamel
Purpose To evaluate whether baseline MRI can help predict survival in patients with unresectable intrahepatic cholangiocarcinoma (ICCA) undergoing transcatheter arterial chemoembolization (TACE). Materials and Methods This retrospective study was compliant with HIPAA and approved by the institutional review board. The requirement to obtain informed consent was waived. The study included 111 patients (mean age, 62 years ± 12; range, 29-86 years), with 44 men (mean age, 61 years ± 12; range, 29-81 years) and 67 women (mean age, 63 years ± 12; range, 34-86 years)...
December 2018: Radiology
Liu Zhen, Chen Jiali, Fang Yong, Xufeng Han, Pan Hongming, Han Weidong
Purpose: Liver cancer is insensitive to chemotherapy. Sorafenib is currently the standard treatment for patients with advanced diseases, with mild survival extension and several intolerable drug-related side effects. The establishment of new treatments is an unmet clinical need. The aim of our study was to assess the efficacy and safety of apatinib, a novel antiangiogenic drug, in the treatment of patients with liver cancer. Materials and Methods: Patients with unresectable or relapsed liver cancer were included in a single center, retrospective, observational study and treated with apatinib until progressive disease or unacceptable toxicity...
2018: Journal of Cancer
Edward Willems, Bart Smet, Franceska Dedeurwaerdere, Mathieu D'Hondt
Intrahepatic cholangiocarcinoma (iCCA) is the second most common primary liver malignancy with poor survival rates. Surgical resection is the only curative treatment option, yet only a small portion of cases are resectable. In unresectable situations, suggested therapy consists of a systemic chemotherapy regimen with cisplatinum and gemcitabine. Selective internal radiation therapy (SIRT) has been proposed as an alternative treatment option and may lead to downstaging of unresectable iCCA to surgery. We present a case of a female patient diagnosed with an unresectable iCCA treated with SIRT in order to obtain downstaging...
August 9, 2018: Acta Chirurgica Belgica
Hai-Jie Hu, Yan-Wen Jin, Rong-Xing Zhou, Wen-Jie Ma, Qin Yang, Jun-Ke Wang, Fei Liu, Nan-Sheng Cheng, Fu-Yu Li
BACKGROUND: We aimed to examine whether inflammation-based prognostic scores could predict tumor resectability in a cohort of hilar cholangiocarcinoma patients with preoperative hyperbilirubinemia. We also sought to investigate the prognostic factors associated with overall survival in the subgroup of patients with an R0 resection. METHODS: A total of 173 patients with potentially resectable hilar cholangiocarcinoma, as judged by radiological examinations, were included...
August 3, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Colin K Cantrell, Jared White
Cholangiocarcinoma is a rare, but invariably fatal primary hepatic tumor that is often diagnosed at advanced stages with minimal options of surgical cure. Relatively few patients diagnosed with cholangiocarcinoma are considered surgical candidates, owing to the extent of the disease at presentation, the presence of vascular invasion or extrahepatic disease, and/or poor functional status with advanced age being most commonly associated. There is no clear consensus for the management of advanced cholangiocarcinomas, as the current literature is typically based on limited patient numbers and anecdotal experiences at best...
May 28, 2018: Curēus
Xingwei Zhang, Rui Mo, Huijun Zhao, Xi Luo, Yunsheng Yang
This article has been withdrawn at the request of the author(s) and Editor. The Publisher apologizes for any inconvenience this may cause. The full Elsevier Policy on Article Withdrawal can be found at
July 26, 2018: Photodiagnosis and Photodynamic Therapy
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No abstract text is available yet for this article.
August 2018: Endoscopy
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