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Cholangiocarcinoma And Surgery

Hong Seon Lee, Myeong-Jin Kim, Chansik An
OBJECTIVES: To investigate the diagnostic accuracy of each LR-M feature defined in version 2017 of the Liver Imaging Reporting and Data System (LI-RADS) and determine the optimal LR-M feature for differentiating combined hepatocellular-cholangiocarcinoma (cHCC-CCA) and hepatocellular carcinoma (HCC) on gadoxetate-enhanced magnetic resonance imaging (MRI). METHODS: Ninety-nine patients with pathologically proven cHCC-CCA (n = 33) or HCC (n = 66) after surgery were identified...
December 14, 2018: European Radiology
Heather M McGee, Todd Carpenter, Umut Ozbek, Katherine Kirkwood, Tzeng Tzu-Chi, Seth Blacksburg, Isabelle M Germano, Sheryl Green, Michael Buckstein
PURPOSE: To evaluate the efficacy of stereotactic radiosurgery (SRS) for spinal metastases from hepatocellular carcinoma (HCC) compared with other radioresistant histologies (renal cell carcinoma (RCC), melanoma, and sarcoma) in terms of local control (LC) and pain control. METHODS: We performed a retrospective review of patients treated with SRS to the spine for metastatic HCC, RCC, melanoma, and sarcoma from January 2007 through May 2014. Radiographic assessment of LC, OS, and patient-reported pain control were analyzed as univariable analyses and with various patient- and treatment-related parameters as multivariable analyses (MVA)...
December 10, 2018: Practical Radiation Oncology
Thuy B Tran, Cecilia G Ethun, Timothy M Pawlik, Carl Schmidt, Eliza W Beal, Ryan C Fields, Bradley Krasnick, Sharon M Weber, Ahmed Salem, Robert C G Martin, Charles R Scoggins, Perry Shen, Harveshp D Mogal, Kamran Idrees, Chelsea A Isom, Ioannis Hatzaras, Rivfka Shenoy, Shishir K Maithel, George A Poultsides
BACKGROUND: The prevalence and characteristics of actual 5-year survivors after surgical treatment of hilar cholangiocarcinoma (HC) have not been described previously. METHODS: Patients who underwent resection for HC from 2000 to 2015 were analyzed through a multi-institutional registry from 10 U.S. academic medical centers. The clinicopathologic characteristics and both the perioperative and long-term outcomes for actual 5-year survivors were compared with those for non-survivors (patients who died within 5 years after surgery)...
December 11, 2018: Annals of Surgical Oncology
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
Yu A Kovalenko, Yu O Zharikov, I A Kukeev, V A Vishnevsky, A V Chzhao
AIM: To determine significant predictors of long-term outcomes of surgery for portal cholangiocarcinoma. MATERIAL AND METHODS: Analysis included 49 out of 84 patients who were operated at the Vishnevsky Institute of Surgery in 2003-2016. Morphological examination (2011-2016) revealed great percentage of following positive variables: micro- (42.9%) and lymphovascular invasion (11.8%), positive resection margin (59.2%), perineural invasion (83.3%), depth of invasion - (83...
2018: Khirurgiia
Kyohei Yugawa, Tomoharu Yoshizumi, Yohei Mano, Noboru Harada, Shinji Itoh, Toru Ikegami, Yuji Soejima, Nobuhiro Fujita, Kenichi Kohashi, Shinichi Aishima, Yoshinao Oda, Masaki Mori
BACKGROUND: Hepatic carcinosarcomas, which include both carcinomatous and sarcomatous elements, are uncommon in adults. Although carcinosarcoma in hepatocellular carcinoma is occasionally reported, carcinosarcoma in intrahepatic cholangiocarcinoma (ICC) is an extremely rare ICC variant. Few such cases have been reported in English and no large study of its clinicopathological features exists. CASE PRESENTATION: Here, we report a 60-year-old man with an asymptomatic hepatic B infection who developed hepatic carcinosarcoma from an otherwise normal liver...
November 26, 2018: Surgical Case Reports
Ryusei Yamamoto, Yasuji Mokuno, Hideo Matsubara, Hirokazu Kaneko, Yozo Sato, Shinsuke Iyomasa
BACKGROUND: Chylothorax is the accumulation of chyle within the pleural space. Chylothorax can occur as a complication after multiple different types of surgery, most frequently after thoracic surgery, albeit with an incidence rate of less than 1%. Chylothorax after abdominal surgery is extremely rare, and there are only a few case reports. CASE PRESENTATION: A 74-year-old Japanese woman presented with jaundice. She was diagnosed as having hilar cholangiocarcinoma and underwent right hepatectomy, caudate lobectomy, extrahepatic bile duct resection, and lymph node dissection after preoperative percutaneous transhepatic portal vein embolization...
November 26, 2018: Journal of Medical Case Reports
Eui Joo Kim, Dong Hae Chung, Yoon Jae Kim, Yeon Suk Kim, Yeon Ho Park, Keon Kuk Kim, Jae Hee Cho
BACKGROUND: Most patients with distal extrahepatic cholangiocarcinoma have developed jaundice or cholangitis at the time of initial diagnosis, which can delay surgery. We aim to evaluate the actual EB-RFA ablation volume and validated the clinical feasibility of preoperative endobiliary radiofrequency ablation (EB-RFA) for resectable distal extrahepatic cholangiocarcinoma. METHODS: The medical records of patients who underwent EB-RFA from July 2016 to June 2017 at a single tertiary academic medical center were reviewed...
2018: PloS One
Ji Hye Min, Kyung Mi Jang, Dong Ik Cha, Tae Wook Kang, Seong Hyun Kim, Seo-Youn Choi, Kwangseon Min
PURPOSE: To assess the differences in early imaging features and progression pattern on CT between intrahepatic biliary metastasis (IBM) and non-mass-forming cholangiocarcinoma (NMFC) in patients with extrabiliary malignancy. METHODS: This retrospective study included 35 patients who were surgically and pathologically confirmed with IBM (n = 14) or NMFC (n = 21) at the time of or after surgery for extrabiliary malignancy. Two observers evaluated the following aspects of biliary lesions on initial or follow-up CT images: location, characteristics of intrahepatic duct (IHD) dilatation, presence of duct wall thickening, and periductal infiltration lesion or periductal expansile mass...
November 7, 2018: Abdominal Radiology
Junji Ueda, Hiroshi Yoshida, Yasuhiro Mamada, Nobuhiko Taniai, Masato Yoshioka, Atsushi Hirakata, Youichi Kawano, Yoshiaki Mizuguchi, Tetsuya Shimizu, Tomohiro Kanda, Hideyuki Takata, Ryota Kondo, Eiji Uchida
At present the only method available to confirm microscopic infiltration of cancer into ductal margins during surgery, is intraoperative histological examination. In the present study, the status of the surgical margins and postoperative course were evaluated to determine any correlation between remnant carcinoma and postoperative survival. All consecutive patients who underwent resection for biliary tract cancer between January 2004 and May 2012 were identified from a database. Positive margin cases were divided into two groups, invasive carcinoma and carcinoma in situ (CIS)...
November 2018: Oncology Letters
Atsushi Nanashima, Naoya Imamura, Masahide Hiyoshi, Koichi Yano, Takeomi Hamada, Teru Chiyotanda, Kenzo Nagatomo, Rouko Hamada, Hiroshi Ito
INTRODUCTION: The present case report demonstrated the successfully radical operation (R0) for the highly advanced cholangiocarcinoma involving hilar hepatic arteries and portal vein, The careful preoperative diagnosis to define the adequate resection area and the expert operation was achieved without postoperative severe complications. PRESENTATION OF CASE: A 55-year-old male was admitted to our hospital with obstructive jaundice, and the perihilar cholangiocarcinoma (PC) was found...
October 25, 2018: International Journal of Surgery Case Reports
Atsushi Nanashima, Naoya Imamura, Masahide Hiyoshi, Koichi Yano, Takeomi Hamada, Teru Chiyotanda, Kenzo Nagatomo, Rouko Hamada, Hiroshi Ito
INTRODUCTION: This case report describes a successful radical operation for a patient with extensive advanced cholangiocarcinoma who had previously undergone intra-abdominal poly-surgery for advanced gall bladder carcinoma. Careful diagnosis to define the adequate division of the right hepatic duct was performed, and the operation was completed without postoperative complications. CASE PRESENTATION: A 61-year-old woman was admitted to a hospital for obstructive jaundice, and extra-hepatic cholangiocarcinoma was found...
October 26, 2018: International Journal of Surgery Case Reports
Fumi Harada, Ryusei Matsuyama, Ryutaro Mori, Takafumi Kumamoto, Daisuke Morioka, Masataka Taguri, Shoji Yamanaka, Itaru Endo
INTRODUCTION: The World Health Organization (WHO) proposed an integrated classification for intraductal papillary neoplasm of the bile duct (IPNB) in 2010. However, IPNB reportedly shows considerable geographic variation. This Japanese single-institution study examined outcomes of surgery for IPNB and the prognostic impact of immunohistochemical mucin expression patterns. MATERIALS AND METHODS: Patients with IPNB were identified from 413 patients who underwent curative-intent surgery for biliary tract (excluding gallbladder) neoplasms from 1992 to 2016 by retrospective macro- and microscopic reevaluation of resected specimens...
October 24, 2018: European Journal of Surgical Oncology
Naveen Kumar Reddy Akepati, Rashmi Sudhir, Sudha Murthy, Zakir Ali Abubakar
Torsion ovary is one of the common emergencies in gynecology requiring surgery. Torsion ovary is generally caused by cystic lesions of ovary and benign tumors. Malignant tumors rarely present as torsion ovary. Krukenberg tumor presenting as torsion ovary is very rare with only a few case reports described in literature. Stomach is the most common primary site (70%) followed by colorectal, breast, lung, contralateral ovary, pancreatic, cholangiocarcinoma, and gallbladder carcinomas. Krukenberg tumor with primary in appendix is relatively rare...
October 2018: Indian Journal of Nuclear Medicine: IJNM: the Official Journal of the Society of Nuclear Medicine, India
Yuka Futsukaichi, Kazuto Tajiri, Saito Kobayashi, Kohei Nagata, Satoshi Yasumura, Terumi Takahara, Masami Minemura, Ichiro Yasuda
Sorafenib, a multiple kinase inhibitor, has been established as first-line standard systemic chemotherapy for patients with advanced hepatocellular carcinoma (HCC). We encountered a patient with combined hepatocellular and cholangiocarcinoma (CHC) who achieved complete remission in response to sorafenib treatment. A 58-year old man with hepatitis C virus (HCV)-induced liver cirrhosis was diagnosed with CHC in segments 6th and 7th of the liver and underwent partial surgical resection. Three months later, CHC recurred as metastases at multiple intrahepatic sites, lymph nodes, and bones, making surgery impossible...
October 29, 2018: Clinical Journal of Gastroenterology
Zhan-Guo Zhang, Yan Chen, Ran Ji, Ya-Jie Zhao, Jian Wang, Lily Robinson, Xiao-Ping Chen, Lei Zhang
BACKGROUND: Synchronous primary cancers in gallbladder and liver are rarely reported. Here we report an unusual case of synchronous cancers of gallbladder carcinoma and combined hepatocellular cholangiocarcinoma. CASE PRESENTATION: Several lesions in the gallbladder and in adjacent parenchyma of liver were discovered in a 65-years-old woman by imaging examination. Surgical resection was performed following a diagnosis of primary gallbladder carcinoma with local hepatic metastasis...
October 29, 2018: BMC Cancer
Cong-Ya Zhou, Yi-Ping Dong, Xiao Sun, Xin Sui, Hong Zhu, Ya-Qin Zhao, Yuan-Yuan Zhang, Clifford Mason, Qing Zhu, Su-Xia Han
Carbohydrate antigen 19-9 (CA19-9) fails to demonstrate the predictive value for early detection pancreatic ductal adenocarcinoma (PDAC). Glypican-1 (GPC1+) exosomes may serve as a noninvasive diagnostic tool to detect early stages of PDAC. Therefore, it is necessary to explore the serum GPC1 levels and determine whether serum GPC1 serves as a novel biomarker for PDAC patients. Blood samples were collected from 156 patients with PDAC, 199 non-cancer controls, and 240 patients with other cancers. Serological levels of GPC1 were examined by enzyme-linked immunosorbent assay (ELISA)...
November 2018: Cancer Medicine
Baljendra S Kapoor, Giovanni Mauri, Jonathan M Lorenz
Biliary strictures can be broadly classified as benign or malignant. Benign biliary strictures are most commonly iatrogenic in nature and are a consequence of hepatobiliary surgery. Cholangiocarcinoma and adenocarcinoma of the pancreas are the most common causes of malignant biliary obstruction. This article reviews state-of-the-art minimally invasive techniques used to manage these strictures. In addition, the roles of (a) recently introduced biodegradable biliary stents in the management of benign biliary strictures and (b) intraprocedural imaging and navigation tools, such as cone-beam CT, in percutaneous reconstruction of the biliary-enteric anastomosis are discussed...
December 2018: Radiology
Stefan Gilg, Per Sandström, Magnus Rizell, Gert Lindell, Bjarne Ardnor, Cecilia Strömberg, Bengt Isaksson
BACKGROUND: Post-hepatectomy liver failure (PHLF) is considered a main reason for death after major hepatectomy. The reported PHLF-related mortality differs largely and the data mainly originate from single centers. AIM: A retrospective, population-based register study was designed to evaluate the impact of PHLF on 90-day mortality after hepatectomy. METHOD: All patients who underwent liver resection in Sweden between 2005 and 2009 were retrospectively identified using the Swedish Hospital Discharge Registry...
October 20, 2018: Scandinavian Journal of Gastroenterology
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
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